Improve and Maintain PART D Star Ratings
Reporting and Intervention for Stars Excellence
The Centers for Medicare and Medicaid Services (CMS) uses Star Ratings to evaluate how Medicare plans perform. Each fall, Star Ratings are released for the upcoming plan year, including ratings for Medicare Part D (Part D) plans that service upwards of 53 million Medicare beneficiaries across the nation. Our Reporting and Intervention for Stars Excellence (RISE) program aims to ensure our intervention and outreach meet our clients’ needs.
Optimizing Your Part D Plan
Combining Mediation Expertise, Access and Care Coordination
Our comprehensive program focuses on positive outcomes for Part D clinical measures.
Have Questions?
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RISE Overview
Automated, Daily Member Qualification Guides Clinical Interventions
Improve Member Adherence and Health
Our proprietary, web-based application is easy to use. Its customizable settings allow health plans to either complete interventions on their own or delegate via a hybrid model. Under both approaches, the program:
- Enables a proactive, comprehensive approach for member engagements related to Part D Star metrics
- Educates members on their drug therapies to enhance understanding and appropriate use
- Supports identification of adherence roadblocks including cost, and facilitates switches to lower-cost alternatives if identified
- Improves member satisfaction
High-Touch Clinical Outreaches
How It Works
RISE supports focused, client-led or delegated member outreaches to improve the following Part D Star Ratings:
- Medication adherence to diabetes medications
- Medication adherence for hypertension (RAS antagonists)
- Medication adherence for cholesterol (Statins)
- Polypharmacy: Use of multiple anticholinergic medications in older adults (Poly-ACH)
- Concurrent use of opioids and benzodiazepines (COB)