One Transition, Multiple Measures: Protecting Quality Revenue in an Outcomes-First Era
With the CY2027 final rule, CMS removed nearly a dozen Star Ratings measures tied to administrative processes, continuing its shift toward clinical outcomes and member experience. Succeeding in this environment requires plans to identify risk as it emerges and intervene before time-critical windows close.
Transitions of care offer one of the highest-leverage opportunities. A well-executed transition can improve readmissions, medication reconciliation, adherence, member-reported outcomes, and experience of care, while avoiding thousands of dollars in costs for every readmission prevented.
Join us to explore how leading health plans are building repeatable workflows that provide real-time visibility into hospital and post-acute stays, including SNFs, and enable existing teams to act while the opportunity remains open.
You’ll learn:
How health plans are protecting quality-linked revenue as the Star Ratings measure set shifts
Why post-acute care and SNF stays are underused levers for quality performance
How care transitions influence multiple quality measures at once
What plans need to identify at-risk members and time-critical HEDIS denominators in real time
Speakers
