PharmMD, the nation's leader in quality Medication Therapy Management (MTM), announced today a new product, PharmMD STAR Solution, to help health and drug plans increase their Medicare CMS Star Ratings.
“This new technology solution ensures that patients will get access to the best care available and helps health plans qualify for new bonuses and rebates that are available through the health care reform bill.”
"We saw an opportunity to help both patients and health plans," said Bo Bartholomew, chief executive officer of PharmMD. "This new technology solution ensures that patients will get access to the best care available and helps health plans qualify for new bonuses and rebates that are available through the health care reform bill."
The Centers for Medicare and Medicaid Services introduced CMS Star Rating to provide an easy-to-understand rating system for health and drug plans. CMS rates plans based on several criteria that range from 1 to 5 stars, with 5 being the best.
Currently, however, only 15 percent of Medicare patients live in an area where 4-star plans or 5-star plans are available. "From a patient care perspective, it's imperative that these plans boost their performance," said Bartholomew. "We also want to help our clients be recognized for their hard work."
Beginning in 2012, health and drug plans that score at least a 4-star rating can earn bonuses of 1.5 percent and upwards to 5 percent after 2013. Those bonuses, however, are based on the scores the health plans earn this year. Currently, most plans would not qualify since the national average is around 3.25 stars.
The four health and drug plans in the country that have the highest score of 5-stars have shown some of the steps plans can take to be improve performance. These include excellent provider relationships, a focus on the beneficiary with responsive, personal customer service and placing a priority on medical and medication management.
"We see this new performance-based bonus structure as an excellent incentive for health and drug plans to do everything they can to increase the quality of their services," Bartholomew said. "Since PharmMD is the quality leader in medication therapy management, we are uniquely positioned to bring that same quality and excellence to our partnering plans."