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6 Ways Remote Patient Monitoring Helps Improve Medicare Star Ratings

The CMS Star Ratings system measures member satisfaction and healthcare quality. Find out how remote patient monitoring improves medicare star ratings.

Graphic representing a 5 star medicare star rating.

 

Are you committed to providing the best quality of care and the highest levels of satisfaction for your Medicare Advantage (MA) members? Offering a remote patient monitoring (RPM) program has a demonstrably positive impact on achieving these goals.

Accessible, high-quality care should not end when a member, particularly a member with a chronic disease, leaves a healthcare facility. RPM helps provide continuity of quality care when a member is at home, thereby improving healthcare outcomes, improving member satisfaction, and reducing healthcare costs —positive impacts that lead, in turn, to better Star Ratings. By employing RPM’s virtual care and interactive devices, health plans give their members a connected and seamless experience.

As asserted by the Centers for Medicare and Medicaid Services (CMS), the Star Ratings system serves to “empower people to make health care decisions that are best for them,” and when it comes to choosing a health insurance plan, providing virtual care will help to make you an attractive choice.

The Star Ratings program evaluates the quality of health services received by members enrolled in MA plans. The 2023 rankings were based on 40 performance measures that collectively address health maintenance, managing chronic conditions, member satisfaction, and proper medication use. Having an effective RPM program can have a positive impact – whether directly or indirectly – on measures in all these areas.

How does RPM do it?

1. Improved Clinical Outcomes

Most payers, providers, and members will tell you that improving clinical outcomes is their highest priority. It is also the primary goal of remote patient monitoring programs.

Employing RPM as part of a care plan delivers significant improvements for a wide variety of clinical measures. Below are a few of the many examples of how RPM has helped members.

  • Plan All-Cause Readmissions: 31% reduction in readmissions
  • Diabetes Care — Blood Sugar Controlled: An average reduction of 1.8 A1C points within six months
  • Controlling Blood Pressure and/or Medicare Adherence for Hypertension (RAS antagonists): 72% of members with sustained hypertension control at 18 months
  • Diabetes Care — Blood Sugar Controlled or Medication Adherence for Diabetes Medications: 81 percent of members with sustained improvement in glycemic control
  • Controlling Blood Pressure: An average reduction in systolic pressure of 15 mm Hg

These and other clinical benefits translate into a 3.3 to 1 return on investment for payers and providers who employ RPM as part of their care strategy.

2. Focus on Person-Centered Care

Remote patient monitoring can be used to help provide a continuum of care for members with any health condition, but it is particularly important to provide such care for members with chronic conditions. Ninety-nine percent of the $3.3 trillion in annual U.S. healthcare costs are attributable to people with one or more chronic health conditions, many of whom are participants in MA plans. That is why RPM providers specialize in providing care, particularly post-acute care, for members with one or more health conditions, such as heart failure, diabetes, hypertension, COPD, asthma, coronary artery disease, chronic kidney disease, mental health conditions, and cancer.

3. Health Literacy and Engagement

An educated and engaged member is a happy and healthy member. Members who are knowledgeable about their condition, allowing them to proactively participate in self-care, have better outcomes. Successful RPM programs provide user-friendly, condition-specific educational content that encourages members to learn more about what they can do on their own to improve their health, such as exercising more, following dietary recommendations, and adhering to their medication regimen.

4. Accessible and Affordable Care

Remote monitoring helps ensure members continue to receive high-quality, affordable care in between provider visits. In addition to daily monitoring of health conditions, RPM programs offer timely access to a multidisciplinary medical team, including RN care coordinators, pharmacists, dieticians, and physician specialists.

5. Promoting Health Equity

RPM helps ensure that everyone gets quality care. Virtual care is at the forefront of bridging the widening gap between our underserved, vulnerable populations and their care teams. RPM brings care to your members instead of inefficiently and ineffectively forcing them to travel to the sources of care. Further addressing care gaps, RPM provides social determinants of health assessments, interactive surveys, and advanced analytics to help identify member-specific risks and develop personalized care plans.

6. Home Sweet Home

Who wouldn’t rather be at home instead of the hospital or the doctor’s office? RPM helps keep members happy and independent at home. It does this not only by improving clinical outcomes but also by providing vital monitoring functions that formerly required a trip to the doctor’s office, such as measuring blood pressure, blood sugar, oxygen levels, and other important health indicators.

Learn More

To learn more about how RPM can help you improve your Star Ratings and increase membership in your MA plans, book a meeting with one of our RPM experts.

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