The Centers for Medicare & Medicaid Services (CMS) shared their much-anticipated Medication Therapy Management (MTM) Comprehensive Medication Review (CMR) rate cut points that will affect STAR ratings for Medicare Part D (MA-PD) plans. In the latest draft of the 2016 Star rating technical specifications, a number of MA-PD plan holders were surprised to find that with the elimination of 4-star thresholds, the ability to achieve a 5-star rating was much more daunting than expected given the historically low average rates of CMR completion that have been reported since the inception of the program. The new thresholds expect a 36.2% CMR completion rate for MA-PD plans to achieve a 3-star rating and more than 76.0% to get a 5-star rating.
Does Your Organization Have the Part D “Smarts” Necessary to Optimize Your Relationship with Part D Plans?
This is a busy time of year for CMS and health plans. The 2016 Star rating preview period is underway and final 2016 ratings will be published soon. Upheaval has been created by the elimination of 4-star thresholds and plans are beginning to understand the impact this will have on their ratings. This is an area that is constantly evolving; therefore, pharma and other vendors seeking to support the Medicare Part D marketplace need to ensure that their messaging and materials reflect the pace and complexity of these changes.
Pinnacle Can Help You
Pinnacle Health Communications, LLC specializes in tailored, strategic educational and marketing solutions for managed market payers. We have the Medicare expertise and experience to help you leverage these evolving measures into clear, compelling solutions for you and your clients. We can help develop programs that are tailored to the needs of payers and members, while using your current infrastructure and asset base.
If you would like to learn more about how Pinnacle can help you, please contact us.