AdhereHealth, a healthcare technology leader in medication adherence insights and health outcomes, announced today the launch of Resolve SaaS, a one-of-a-kind solution to navigate health plan consumer engagement for Star Ratings initiatives. The Resolve SaaS solution enables Medicare Advantage plans to efficiently provide a holistic platform for their internal clinical teams and aligned provider network to drive necessary quality improvement for health plan members.
The Adhere cloud-based platform includes resource planning, call center integration, data-driven intelligent clinical workflows and robust data visualization to maximize clinical engagement for Medicare Advantage Star Ratings. Adhere's native analytic capabilities delivers daily stratified gaps in medication adherence, HEDIS quality measures, social determinants of health (SDOH), Medication Therapy Management (MTM) and consumer experience, such as Consumer Assessment of Healthcare Providers and Systems (CAHPS) and Health Outcomes Survey (HOS) improvement − all delivered through a streamlined customer relationship management (CRM) system.
"With the Centers for Medicare & Medicaid Services (CMS) change for the Medicare Advantage Star Ratings 2021 contract year to quadruple-weight CAHPS measures, the government has decidedly placed an emphasis on consumer experience. Most health plans use a combination of antiquated case management tools with spreadsheets and measure campaigns to transactionally close gaps," said Jason Z. Rose, CEO of AdhereHealth. "The effect is more plans will fall below the 4-Star threshold and not partake in Quality Bonus Payments (QBP). With consumer experience dominating the weighting, a consumer-centric approach is critical to compete for the value-based care reimbursement."
In the highly competitive Medicare Advantage vertical, plans must transform their Star Ratings strategy to shift to a holistic, consumer-centric approach that closes gaps in medication adherence while delighting their membership through positive experiences. The Adhere platform uses available health plan and consumer data to produce near real-time target and stratification of at-risk quality and experience measures. The intelligent clinical workflow solution guides clinicians in their engagement with consumers to address SDOH, and close gaps in care by managing medication adherence and synchronizing medications for pharmacy partners.
By integrating health plan benefits, community resources and provider care coordination, the Adhere platform systematically builds momentum with consumer's individualized quality improvement. With the comprehensive solution focus, and the addition of Resolve's SaaS capabilities, the Adhere platform can now impact 80.5% of the Medicare Advantage Star Ratings weighting.
"Because consumer engagement is a common ingredient in both medication adherence and consumer experience, health plans that integrate both will drive better value-based care for their membership," said Rose. "A strategic commitment to medication adherence and consumer experience improvement is essential for Star Ratings and other pay for performance programs."
To learn more about the Adhere SaaS solution, visit https://adherehealth.com/solutions/resolve-health-plans/