Quality Solution

Wakely Quality Analytics takes a holistic and collaborative approach to quality measurement, leveraging actuarial analytics, data science, and program management experience, to inform your Star strategy and drive Star performance. Our client-centric solutions and services go beyond measure run to include predictive analytics of end year-results, help you set meaningful targets based on projected next-year Star Rating cut-points, and recommend actionable steps to execute your strategy. We provide wrap-around consulting and interpretation of performance results to glean insights into data, patient, population, and provider level opportunities to maximize your score.

We can help you

  • Establishing year-around analytics to improve Stars Rating performance
  • Track, predict, and model your Star Rating 
  • Set meaningful targets based on Medicare Stars cut point projections inclusive of new CMS methodologies
  • Get ready for Digital Measurement and other imminent program changes
  • Impute race and ethnicity for HEDIS measurement stratification and enable data collection to advance health equity efforts
  • Uncover key drivers of your measure performance by provider, member, and geography
  • Customize your reporting with targeted data flows for measure - specific member engagement
  • Assess your data flows and transformation logic and untap new clinical data sources
  • Set up value-based payment or incentive models to drive improvement and estimate revenue implication
Wakely has developed a tool that enables year-round estimation and scenario testing contract level Star Ratings. There is significant time lag between the collection of quality performance data, the public release of data, and the impact on MAO revenue. MAOs need to continually deploy operational resources toward maintaining and improving quality measures, oftentimes with little to no insight into the ultimate impact on contract level rating. The Wakely Stars Calculation Tool helps to close business intelligence gaps between measure-level performance and contract level rating. The tool does so by enabling MAOs to scenario test the potential contract-level impact of measure-level improvements. MAOs have finite funding and resources to deploy toward Star Rating efforts – steer those resources more effectively with the Wakely Stars Calculation Tool!

Historical Data

There is no need to waste time compiling the extensive historical Star Rating and enrollment data published by CMS. We have done it for you! The Stars Calculation Tool houses and nimbly retrieves historical measure-level performance values, Star Ratings, cutpoints, and more. Our year-over-year comparison breaks down the most recent two years of Star Ratings to quickly reveal the driving measure types, domains, or data sources of the change.

Scenario Testing

Easily scenario test measure-level values, cutpoints, or Star Ratings to determine the potential impact on overall contract Star Rating.

Address questions such as:

How do I invest efforts to balance the interplay between measure-level Star Ratings, improvement ratings, and the reward factor? Which measures should my organization focus on, to achieve an increase in contract-level star ratings? What is the financial impact of a change in Star Rating for the upcoming benefit year, and how will this impact my plan benefits and margin?

Wakely Quality Team