The Shift in Star Ratings That Health Plans Can't Ignore
Transitions of Care (TRC), Medication Reconciliation Post-Discharge (MRP), and Plan All-Cause Readmissions (PCR) significantly affect health plans' Star Ratings.
If you're still using claims data to manage care, you're already too late, as critical information about discharges, medication changes, or ED visits arrives weeks after a critical health inflection point.
care managers lose the opportunity to act when it matters most. You're managing complications instead of preventing them.
Transitions of care are where coordination most frequently breaks down, and where health plans have the greatest opportunity to influence outcomes across multiple quality measures.
Effective post-discharge coordination creates a compounding impact, including better medication adherence, closed chronic care gaps, and stronger member engagement that breaks recurring utilization patterns.
Author's summary: Health plans must adapt to new star rating measures.
More News
- Ørsted sells 50% stake in Hornsea 3 offshore wind farm for $6.5bn
- Ørsted secures $6.5bn from Apollo to co-fund Hornsea 3 offshore wind farm
- John Lewis 2025 Christmas advert stars classic '90s house banger
- John Lewis unveils tear-jerking Christmas advert set to iconic 90s club classic
- John Lewis Christmas advert music Where Loves Lives to become charity single
- Ghana's economy stabilising under President Mahama – Professor Opoku-Agyemang