On Wednesday, June 8 at 1:00 p.m. EDT ACHP hosted a Quality Learning Network webinar. These events are held throughout the year as opportunities for the quality staff at ACHP’s member organizations to learn from each other around quality measurement and improvement. This meeting focused on CMS Medicare Advantage (MA) Star Ratings Part D performance, which has become an increasingly important component of the CMS MA Star Ratings. Fifteen of the 47 measures are related to pharmacy coverage. Many are classified in the higher-weighted experience/access and outcomes categories leading to an overall contribution of about 35 percent. Therefore, ACHP members have expressed interest in learning how to improve in this area.
During this web conference we heard from two plans about initiatives they have implemented to achieve higher Part D performance.
Stacey Dalton, Medicare Part D manager at Presbyterian Health Plan, presented on the plan’s strategies that have led to high scores on the newer MTM program comprehensive medication review completion rate measure. Presbyterian assessed barriers to engagement in its MTM programs and then designed solutions to increase engagement. These have included developing simpler language in member communications, easing administrative burdens and clearly highlighting drug improvement opportunities to members. Presbyterian has found that high engagement is possible but that resource intensive strategies tend to be more successful.
Dan Rehrauer, senior manager of MTM programs at HealthPartners, presented more broadly on the plan’s strategies that have led to high Part D performance. To increase medication adherence, HealthPartners formed a multi-stakeholder work group that could comprehensively look at barriers and identify opportunities. It also uses technology tools that track adherence to make all interactions with members more personalized and effective. HealthPartners has evolved to a broader approach of medication optimization designed to help manage medication information, dispensing, adherence and tracking. Rehrauer closed by talking briefly about a campaign based on behavioral economics principles to increase the plan’s MTM program engagement.
The slides are attached and a recording are available here.