Matrix Medical Network Research Highlights Five Critical Factors for Achieving High Star Ratings

Eighty-Five Percent of Health Plan Executives Surveyed Say High-Touch Prospective Assessment Does Double-Duty in Capturing Information for Stars and Future Care Management Programs

SCOTTSDALE, Ariz., Dec. 10, 2013 (GLOBE NEWSWIRE) -- Matrix Medical Network, the national leader in providing prospective health assessment services for Medicare Advantage (MA) plan members and one of the largest employers of Nurse Practitioners (NP) in the country, has released a new research brief highlighting five critical success factors that health plans with four- and five-Star measure ratings use to achieve and maintain these ratings.

The survey also confirmed that 85 percent of surveyed health plan executives say that the high-touch prospective assessment does double-duty in capturing information for Stars and future care management programs.

"As the Centers for Medicare and Medicaid Services narrow payments to four- and five-Star plans, health plans are becoming more sophisticated in their Star strategies," said Kim Rosengren, vice president of marketing for Matrix Medical Network, who conducted the survey and led the data analysis work. "We asked several thought leaders in this area, from major health plans, to share their views of the quality and Stars horizon. We validated that leading plans focus on five critical success factors to achieve high Star measure ratings; many of the same factors also lead to more focused member care."

The five key factors to drive five-Star success were identified as:

  • Provider collaboration is critical
  • Most Star-activities start with data collection
  • Incentives help but are not the only answer
  • Stars improvement activities must be integral to the health plan operations and not a stand-alone project
  • A focus on the member as a whole patient and not as a quality score

"We see that health plans with four- and five-Star quality scores focus on high-touch member care programs, first and foremost," said Ms. Rosengren. "High-quality Star scores and better clinical outcomes tend to go hand-in-hand when the primary focus of health plans is on member care."

Matrix gathered information from health plan executives ranging from vice presidents to medical doctors during its best practice session on improving HEDIS and Star measures at the 2013 America's Health Insurance Plans Medicare Conference in September. This research brief is the first in a series of Star Accelerator reports and highlights the best practices. Read the Matrix research brief: Health Plans Share Best Practices to Improve Star Measures

About Matrix Medical Network

Matrix is headquartered in Scottsdale, Ariz., and provides prospective health assessment services that help health plans provide high-quality care while managing costs. Having pioneered the use of a national network of highly-trained employee Nurse Practitioners to conduct medical assessments in member homes or nursing facilities, Matrix is dedicated to improving the quality of health care in the U.S. Matrix is owned by Welsh, Carson, Anderson & Stowe, a leading private equity investment firm. For more information, visit


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