Perform+ Stars: AI solution for CMS Stars improvement

The dynamic and complex nature of the CMS Star program makes it difficult for health plans to strategize improvement programs, as the measures, weights, and cut-points are moving targets that keep changing every year.

PERFORM+ Stars combines our healthcare expertise, data science proficiency, and embedded intelligence framework to deliver substantial improvements across the clinical value chain, ensuring holistic Star rating improvement. It provides a single window to track performance across all contracts, with performance trends & benchmarks to provide actionable insights & enable decision support.

Key Business Use Cases:

Improved Projection of Performance: Specialized dashboards to help predict end-of-year performance which can help improve target setting

Improve Member Engagement: Prioritize “high value” members and providers based on impact and engage ability scores.

Solution Features:

Measure Analysis: Inbuilt tabular and graphical views to provide detailed visibility on current ratings, Projected ratings and Goal ratings. What-if analysis to predict the impact of change in ease of closure, cost, available manpower, etc.

List Prioritization: Detailed view of prioritized providers and members that have a high potential for performance improvement. Easy to filter members and providers for each star goal based on their impact-ability and likelihood of engagement.

Recommendation Engine: AI-powered Recommendation engine that provides end-of-year performance projections based on historic trends and current performance. Also makes available recommended goals for Star ratings, with additional details such as ease of closure, cost of closure and available resources.