Medallia Launches Medicare Stars Solution


Medallia, a customer and employee experience solutions provider, released Medallia Medicare Stars Solution to help health plans proactively improve their Medicare Star Ratings by transforming the member experience.

Medallia’s Medicare Stars solution connects Stars member experience measures and [Consumer Assessment of Healthcare Providers and Systems CAHPS)] survey questions to real-time signals, which can be monitored continuously across the entire member journey.

The new dashboards and signal capture techniques will provide actionable insights to Stars leaders, customer service, pharmacy, benefits, and others throughout the organisation.

“Currently most health plans are retroactive in their approach and only have CAHPS surveys and mock surveys to help guide improvements,” said Rex Wallace, owner of Rex Wallace Consulting and former vice president of Medicare and Stars Ratings for Cambia Health Solutions.

“I am thrilled to partner with Medallia on the development of this solution to provide health plan executives real-time member feedback to improve Star Ratings.”

The Centers for Medicare and Medicaid Services (CMS) uses a Star Rating System to measure how well Medicare Advantage plans perform. For the 2020 Star Ratings, member experience measures comprised 31 per cent of the entire weight of the ratings, and these measures will increase to 58 per cent for the 2023 Stars. Providing positive member experiences will be required to achieve a 4+ Star Rating.

“In the past, there was little health plans could do to stay informed on their member experience throughout the year,” said Toni Land, head of healthcare experience at Medallia.

“By breaking down silos across the organisation to create a unified view of feedback and experience data, the entire organisation is empowered to take action. Being able to monitor the member experience in real time enables payers to provide the highest level of service while also receiving the highest level of reimbursements.”