Become a Star: What MA-PD Plans can learn from Mickey Mouse
The Five Star Quality Rating System for Medicare Advantage Plans is run by CMS, and was put in place as part of an effort to help educate consumers on quality, and to make quality data more transparent.
Universal assets of a successful business are the links in Disney’s “Chain of Excellence”:
- Leadership excellence,
- people management,
- quality service,
- brand loyalty and
- inspiring creativity
are lessons which have been carefully developed by the Disney organization in its never-ending pursuit of excellence.
For 2012, the Stars consist of 50 measures hailing from 5 different rating systems: HEDIS, CAHPS, CMS, HOS, and IRE. Data to support these Star ratings come from surveys, empirical observation, administrative (claims) data, and medical records. CMS Star ratings are published annually and are available for viewing by all Medicare members prior to Open Enrollment and MAS-PD plan reimbursement are substantially tied to Star Rating scores.
Health plans have become adept at harvesting the “low-hanging fruit” consisting of clinical metrics as seen with HEDIS-like measures; however, attested by only three 5-Star plans for 2011, most MA-PD plans struggle with managing the CAHPS and HOS related measures. These are direct measures of customer satisfaction based on member surveys.
The struggle for MA-PD plans is how to move the needle for customer satisfaction. Health Plans are uniquely positioned to take many Disney concepts and adapt for inclusion. A couple of examples: healthcare has a strong, obvious common purpose that can be leveraged to align employees around improving the patient experience.
At Disney, the chain of excellence starts with leadership, moves into how you take care of your people, how your people then take care of your customers. And the loyalty and the financial results, for us, is not the goal, but rather it’s the reward for doing something else really well, and that’s that guest experience.
Corporate culture needs to be deliberate, by design, not by accident. Measureable goals then align to that. For example, crucial to Disney’s strategy was the atmosphere, and Walt wasn’t above picking up trash on Main Street since it was important to him. For Disney, “wow” experiences aren’t the big things, but instead are all the little things. These are low cost additions that are sustainable. Paying attention to every detail of the delivery, and repeating it successfully, all add up to “wow!”
Companies can be proactive or reactive. To achieve excellence in customer satisfaction, Medicare Advantage plans must evaluate what within the existing business model works and what is missing the mark.
Satisfied members are loyal. Loyalty is really the reward for continually delivering on the brand’s promise: a promise of magical experiences, experiences that exceed expectations. At the Gorman Health Group, we help our clients’ laser focus on creating, nurturing and reinforcing life-long relationships at every touch point.