Case Study

CMS Taskforce Helps Health Plan Clients Improve 5-Star Survey Ratings

2 months ago

For Medicare Advantage health plans, CMS Star Survey results are an extremely important measure of quality and experience. Incentive payments are linked to a plan’s score, and many members weigh scores heavily when choosing to stay with their plans or move to new ones.  

The Challenge 

Medicare Advantage health plans understand the importance of driving higher CMS Star Survey Scores. 5-Star Survey scores correlate to:   

  • Millions of dollars in CMS performance incentives  
  • Stronger online reputation 
  • Enhanced standing for member plan choice among competitors 
  • Demonstrated excellence in quality and member experience 

The Solution 

ResultsCX supports multiple Medicare Advantage health plan clients. To ensure 5-Star member support, the ResultsCX CMS task force focused on: 

  • Instituting a shared best practices repository 
  • Preparing for progressive ratings difficulty 
  • Training for accuracy and timeliness, as measured by CMS secret shoppers 
  • Analyzing agent patterns for better Star Survey-measured quality 
  • Applying skill base and competence with Star System across multiple clients  

The Results 

By making Star Ratings a cultural component of Medicare Advantage support and taking an empathetic approach, the CMS Task Force ensures client support matches 5-Star quality performance: 

  • Three clients increased their ratings by one star 
  • One client increased its rating by two stars, from 3 to 5 
  • Having achieved five-star ratings, three clients are now able to sell their plans year-round, not just during the annual enrollment period