Most Medicare health plans invest significantly on a variety of quality programs to improve Centers for Medicare & Medicaid Services (CMS) Medicare Star Ratings, achieving a four- or five-star rating is critical for their success. Once achieved, maintaining this rating remains challenging, since plans must frequently update best practices to reflect evolving standards of care and respond to the rising performance benchmarks.

Argus offers the Star5™ program, a unique set of star rating tools and services which help Medicare plans improve member quality of care and achieve a high star rating. Specifically, our solution drives measurable results for three CMS priorities:

  • How members rate the Medicare plan’s services and care
  • How well healthcare providers detect disease and keep members healthy
  • How well the Medicare plan helps members safely use medications

Star5 is flexible, allowing Medicare plans to implement a tailored star rating strategy. Components include analytics, a simulation dashboard, clinical interventions, and reports. We collaborate with Medicare plans to customize Star5, including the option of analytics or analytics plus interventions, to meet the unique needs of each plan.

The Star5 solution offers a “smart monitoring” application for all star measures, analytics, and clinical interventions for both Part C and Part D (medical and pharmacy). We continuously analyze demographic, provider, pharmacy, medical, and lab data. Real time interval reporting and data visualization allows plans to know in advance if they are not meeting their star rating goals and offers actionable insights. These analytics, in combination with our predictive model, allows us to segment target members and allow health plans to stratify risk to better determine intervention intensity.

Additionally, Argus can help health plans maximize a variety of communication channels, enhancing consumer satisfaction and engagement, as well as promote communication between the physician and patients.