Medicare Star Rating System Drives Change For Transportation Industry

Brendan McNiff
medicare star ratings system

What’s the first thing that comes to mind when you hear star ratings? IMDb? Amazon product reviews? Right, me too. But there’s something else, arguably more important, that also has star ratings – Medicare Health Plans.

That’s right, every year, Medicare Advantage health plans are given a 5 Star Rating to determine the overall quality and performance of each plan. The categories for determining the overall rating of the plan are:

  •       Staying healthy: including screening tests, vaccines, and check-ups
  •       Managing chronic (long-term) conditions: ensuring members are getting the proper tests for their medical conditions
  •       Member experience with health plans: providing members’ ratings of the plan
  •       Complaints: occurrences and frequency of having issues with the plan
  •       Customer Service: overall experience members has with the plan

As Medicare Advantage now allows more options and new benefits to Medicare beneficiaries, Medicare Star Ratings only benefit from understanding all barriers to care, including transportation. If you’ve been reading other awesome blogs on our website, whether it’s for one of the many health systems, health plans we work with, Roundtrip is all about providing greater access to transportation. By making it easier for Medicare recipients to get access to the care they need, transportation will start affecting Star Rating programs across the country.

Think transportation isn’t a big deal when it comes to quality? I beg to differ! Most US Health Systems rate transportation as a top 5 barrier to care.  The patient experience doesn’t start when the patient enters the facility. Instead, the patient’s experience starts at their first touch-point to the health system – transportation.

Adequate transportation to healthcare also checks the box for preventative care (staying healthy), treating current ailments (managing chronic conditions), and elevates the customer experience. By removing simple barriers such as physically getting to the appointment, patients and health plan members can feel less alone when it comes to making an important appointment or treatment. That’s what really matters. We’re all in this together.

As CMS continues to evolve it’s approach to Medicare, Health Plans will also be shifting to view transportation as an important part of the overall quality of a patient. We’re proud to be working with health plans to improve their Star Ratings and ensure transportation increases the overall quality of Medicare Advantage health plans.