Boosting Medicare Advantage Star Ratings Amid Industry Challenges
"Nymbl Science's Innovative Approach to Boosting Medicare Advantage Star Ratings Amid Industry Challenges"
The landscape of Medicare Advantage (MA) Star Ratings has witnessed a significant decline entering into 2024, leaving plans to pursue solutions to get back on track for 5 stars. Only 31 plans earned a 5-star rating, down from 57 in 2023 and 74 in 2022, reflecting an overall decrease in performance.1 The average star rating dropped from 4.14 in 2023 to 4.04 in 2024, prompting a reevaluation of strategies within Medicare Advantage.1
In the midst of this challenging environment, Nymbl has emerged with true innovation, introducing a digital balance and mobility enhancement platform designed to address the complex issues contributing to the decline in star ratings. By focusing on Health Outcome Surveys (HOS) and member experience, Nymbl seeks to revolutionize how MA health plans approach quality improvement.
Challenges in Improving Star Ratings: Improving Health Outcome Survey (HOS) performance has been a persistent challenge for MA health plans. Traditionally, efforts have been centered around facilitating provider-led initiatives, often yielding mixed and difficult-to-interpret results. The complexities of workflows, variable member perceptions, and the timing of interventions in a fast-paced environment have hindered progress. The COVID-19 pandemic exacerbated these challenges, requiring a transition from in-person to remote engagements.
Nymbl Science recognized an opportunity to shift tactics by deploying a scalable solution – a patented, digital balance and mobility training program for older adults.
Nymbl Science's Impact on Star Ratings and Health Outcomes: A feasibility study conducted in collaboration with a national top Medicare Advantage plan demonstrated Nymbl's effectiveness. In a study involving 42,000 high-risk MA members, Nymbl participants showed a remarkable 38% increase in discussing fall risk with their healthcare provider, compared to the control group. Among those members engaging in at least 12 Nymbl sessions, the impact grew to 54%. Additionally, participants were 30% more likely to leave the high-risk fall category.
The positive outcomes extended beyond discussions, with 62% experiencing clinically meaningful improvement in balance, 48% feeling steadier walking, and over 70% no longer fearing loss of balance at home.
Broader Impact on HOS Outcomes: Nymbl expanded its impact beyond fall risk to include physical and mental health measures. Results from a user experience survey involving 6,500 enrollees showcased significant improvements. Regarding physical health, 38% of enrollees reported increased moderate-level activity participation, while 35% reported being less limited by their physical health. For mental health, 34% of respondents felt calmer and more peaceful.
The impact of Nymbl on health outcomes correlated with improved balance and confidence, leading to increased mobility and functional participation. This approach directly addressed the primary concern of aging individuals – declining mobility that limits the ability to age in place.
Member Experience and Star Ratings: The positive outcomes from Nymbl interventions translated into improved member satisfaction and quality of life. Nymbl’s partnerships with MA plans demonstrated significant benefits, with over 66% of older adults engaging with Nymbl reporting greater satisfaction with their MA plan, leading to a 48% increase in the likelihood of renewing their Medicare Plan.
Navigating the Evolving Landscape: As MA star ratings face challenges and changes in methodology, payers are advised to adapt. Nymbl's success underscores the importance of embracing technology, prioritizing health equity, and enhancing the overall member experience. The program aligns with recommendations for measuring against future reporting criteria, focusing on social determinants of health, and investing in technology for patient engagement.
In conclusion, Nymbl has demonstrated a transformative approach to address the complexities of Medicare Advantage star ratings. By prioritizing member health outcomes, satisfaction, and mobility, Nymbl not only offers a solution for improving Star Ratings but also contributes to the broader goal of enhancing the quality of care provided by MA plans. As the industry navigates changes, innovative programs like Nymbl stand out as beacons of hope, driving positive change in the healthcare landscape.
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