ConstellationSM Ratings Advisor modeling program is first to link Star Rating improvements to projected CMS quality bonuses and total plan performance
NEW ORLEANS, Feb. 10, 2014 /PRNewswire/ -- Presenting today at the Institute for International Research 11th Annual Medicare Congress, Express Scripts (NASDAQ: ESRX) is introducing a breakthrough modeling tool to help Medicare health plans simply and effectively navigate Centers for Medicare and Medicaid Services (CMS) Star Ratings, and identify the best strategies for enhancing plan performance across all 51 Part C and Part D measures.
Drawing upon more than a decade of experience serving the Medicare market, Express Scripts' ConstellationSM Ratings Advisor enables plans to pinpoint the most effective and efficient strategies to improve Star Ratings. Constellation also is the only tool to link those improvements to CMS Quality Bonus Payments, iFactor ratings and total plan performance.
"To remain competitive and sustain a top-performing plan in the Medicare Advantage Prescription Drug Plan (MA-PD) and Prescription Drug Plan (PDP) market place, health plans must provide exemplary service, rising above today's standards and planning for tomorrow's higher performance thresholds," said Snezana Mahon, PharmD, Sr. Director of Medicare Product Management, Express Scripts. "Constellation helps plans identify every opportunity—no matter its size – to improve plan performance, achieve above-average star ratings, attract and retain members, and receive CMS quality bonus payments."
Constellation's patent-pending, four-step action planning helps plan sponsors:
- Capture historical performance and test and model improvement scenarios;
- Set goals by addressing Part C and D measures (all 51 metrics CMS evaluates);
- Identify targeted high-impact improvements – big and small – that can drive total plan performance; and
- Create a roadmap for improvement across all plans to ensure ratings consistency and iFactor performance.
Through the use of Constellation, health plans can expect improved understanding of their current Star Ratings performance and a blueprint to improve future performance.
"Forty-five percent of Medicare beneficiaries chose 4- and 5- Star plans for 2014, compared to 37 percent in 2013," said Mahon. "Constellation takes the guess-work out of improving Star Ratings, helping plans quickly identify which improvements have the greatest and most successful impact."
To learn more about Constellation during the Medicare Congress, please visit Express Scripts at Booth #1.
About Express Scripts Government Programs
Express Scripts has more than a decade of proven experience and deep capabilities providing pharmacy benefit management services to plan sponsors working in regulated healthcare markets. Express Scripts' Government Programs employees are dedicated to serving Medicare, Medicaid and public exchange marketplace plans and members. Regulated-markets clients benefit from Express Scripts' unmatched compliance rigor, consultative partnership and clinical care innovations. Express Scripts offers Medicare, Medicaid and public exchange clients a wide range of innovative products and consultative solutions that deliver a more tightly managed, cost effective benefit while improving healthcare quality for those we serve.
About Express Scripts
Express Scripts manages more than a billion prescriptions each year for tens of millions of people. On behalf of our clients – employers, health plans, unions and government health programs – we make the use of prescription drugs safer and more affordable. Express Scripts uniquely combines three capabilities – behavioral sciences, clinical specialization and actionable data – to create Health Decision Science, our innovative approach to help individuals make the best drug choices, pharmacy choices and health choices. Better decisions mean healthier outcomes.
Headquartered in St. Louis, Express Scripts provides integrated pharmacy benefit management services, including network-pharmacy claims processing, home delivery, specialty benefit management, benefit-design consultation, drug-utilization review, formulary management, and medical and drug data analysis services. The company also distributes a full range of biopharmaceutical products and provides extensive cost-management and patient-care services.
SOURCE Express Scripts Holding Company