Boost Your CMS Star Ratings with a Scalable Population Health Platform

Privacy and security of patient and member information is at the foundation of the Greenspace platform. We take this responsibility very seriously and have implemented significant measures to safeguard patients’ personal health information that exceed industry standards and best practices. Greenspace is SOC 2 Type II compliant and conforms to digital and physical security protocols (including PIPEDA and PHIPA), with SSL-secured access, AES encryption at the filesystem level, and firewalls protecting all data. We take many additional precautions to protect privacy including: requiring strong passwords, automatic logouts, automatic access logging, secured data backups, two factor authentication and restrictive data access procedures. All data and information is stored in Canada.

CMS Star Ratings are annual quality scores (1–5 stars, with half-star increments) published on Medicare.gov based on performance in measures like member experience, preventive care, and outcomes. Ratings influence enrollment decisions, quality bonus payments (QBPs), and long-term plan sustainability.

CMS Star Ratings have a direct influence on several priority areas:

• Bonus payments: Only plans with ≥4 stars receive Quality Bonus Payments;
• Rebate percentages: Higher-performing plans earn larger rebates from CMS benchmarks;
• Special Enrollment Period (SEP): Only available to 5-star plans, from Dec 8 through Nov 30, giving them year-round enrollment advantage.

Ratings are determined across four levels:

1. Individual Measures: e.g., blood pressure control, customer service responsiveness.

2. Domains: Clusters of related measures (e.g., Member Experience, Staying Healthy).

3. Summary Ratings: Separate composite scores for Part C (medical) and Part D (drug).

4. Overall Star Rating: Combined score for MA-PD plans and used for bonus eligibility and plan visibility.

To evaluate the quality of MA plans by domain, CMS relies on a combination of survey instruments and performance metrics that assess both patient/member experience and quality of care:

• HEDIS (Health Effectiveness Data and Information Set): Over 90 standardized performance measures;

• CAHPS (Consumer Assessment of Healthcare Providers & Systems): Surveys capturing member satisfaction, weighted at 2×;

• HOS (Health Outcomes Survey): Tracks functional health and wellness outcomes.

Greenspace’s population health platform can align your strategy with high-weight measures by:

• Delivering personalized outreach to elevate CAHPS scores (e.g., “Getting Needed Care,” “Provider Communication”);

• Automating preventive care reminders for HEDIS gaps;

• Mitigating risk and readmissions via predictive analytics;

• Embedding feedback tools (proxy surveys) for timely course corrections.