Marketplace snapshot: Integrating quality and risk adjustment

Just a short note about a Webinar we did last week, hosted by MCOL, and focused on the integration of quality and risk adjustment.

While discussing the relationship between risk adjustment and quality for health plans, we asked three questions during that drew some interesting answers:

First, we asked about the Star ratings of the participants.  As it turned out almost all the attendees were from 4 Star or better plans.  The message I took from that is the plans that are already doing well on quality measures are determined to do better.

The second insight was that 2/3 of the attendees had already integrated their Stars/HEDIS with their risk adjustment departments.  The good ones have figured out that risk adjustment and quality are inseparable.

Finally, ¾ of the attendees had not yet incorporated data collection for HEDIS and Stars into their prospective member evaluations.  That strikes me as a missed opportunity, but these are good plans and I suspect that will change.

So the rich get richer and work smarter. I guess that should not be too much of a surprise.