Even in the midst of COVID-19 concerns and changes in healthcare practice, payers and pharmacies need to continue to be focused on the CMS Star quality care measures. One measure in particular, the Part D “Statin Use for Persons with Diabetes” (SUPD), will undergo changes over the next few years.
How SUPD weights are changing
For 2021 and 2022 Star Ratings, SUPD will be a 3x weighted measure. The data used to calculate this measure is collected in 2019 (for 2021) and 2020 (for 2022). The 2019 data should not be affected by the coronavirus pandemic, while the 2020 data is something that the industry will be getting further direction on as more is revealed regarding the timing and implications of this national crisis.
Additionally, in 2023 (data collection year 2021), SUPD will be going back to a 1x weighted measure, and it will become a process measure rather than an intermediate outcome measure.
This was decided after CMS re-evaluated their initial thoughts, based on feedback from the industry that this type of measure is really a process measure. The decision aligns with CMS’s definition in the April 2019 final rule that process measures capture the health care services provided to beneficiaries which can assist in maintaining, monitoring, or improving their health status.
Summary of SUPD changes
|APPLICABLE STAR RATING YEAR||YEAR DATA COLLECTED||MEASURE
|2020||2018||1X||INTERMEDIATE OUTCOME MEASURE|
|2021||2019||3X||INTERMEDIATE OUTCOME MEASURE|
|2022||2020||3X||INTERMEDIATE OUTCOME MEASURE|
AllazoHealth uses artificial intelligence to make a positive impact on individual patient adherence. We help payers and PBMs increase the effectiveness of patient engagement programs that focus on quality ratings. Adherence measures such as SUPD/SPC are heavily weighted, so improving patient adherence can have a dramatic effect on star ratings, HEDIS scores, QRS ratings, and Medicaid quality measures.
Have more questions about changes in quality ratings?
Dr. Linda Schultz
VP of Customer Success
(888) 464-2776 x715
Improving the Effectiveness of Adherence Interventions by
5.45xWe worked alongside Blue Cross Blue Shield of North Carolina and their call center vendor to launch one of our biggest programs, working to improve adherence rates across their population of 104,392 Medicare Advantage Part D (MAPD) patients. We found that AllazoHealth targeted interventions accounted for 5.45 times the uplift in adherence compared to traditionally targeted interventions.