Clinical Quality and Stars

The Optum Clinical Quality and Stars solution helps organizations improve and maintain high ratings in the CMS Medicare Health and Drug Plan Quality and Performance Ratings (Stars) program as well as the Healthcare Effectiveness and Data Information Set (HEDIS®) program. We supply expert consultants with broad-based experience, innovative processes, and analytic technology to help organizations measure quality and evaluate outcomes more efficiently. Some customers implement our improvement recommendations directly; others employ our consultants to apply enhancements using our proven operations processes.

Optum’s solution:

• Helps organizations understand their current HEDIS and Stars ratings
• Provides experience-based recommendations to improve ratings including: 
  • enhancing customer satisfaction
  • improving customer survey results
  • aligning provider networks along accessibility and performance needs
  • using analytics effectively
  • implementing Stars dashboards
  • engaging providers and members to improve health care
• Measures and assesses quality and outcomes to maintain improvement
• Reduces medical costs and supports receipt of Stars bonus payments