Clear vision, clear victory

The situation

The Centers for Medicare & Medicaid Services (CMS) periodically updates its Star Rating Program, which rewards Medicare Advantage (MA) plans with bonuses and other incentives based on how they perform across certain quality measures (health outcomes, patient experience, access to care, etc.). Because high ratings drive competitive advantages, plans invest in programs designed to improve performance on Stars measures.

As part of a rulemaking process, CMS proposed to eliminate 12 MA Star Rating measures, including a beneficial health screening service.

The challenge

An entity providing the screening service on a contract basis to MA plans engaged us to persuade CMS to maintain the screening Star Rating measure.

McDermott+ recognized that reversing the proposal would require more than a traditional comment letter. Success would depend on quickly building support across a diverse group of stakeholders and demonstrating the measure’s value to patients, providers, health plans, and the healthcare system.

Our approach

We immediately mobilized a coalition of stakeholders with a shared interest in preserving the measure. Because McDermott+ already had existing relationships, including in some cases client relationships, with many of the stakeholders, we were able to quickly assemble collaborators and coordinate advocacy efforts across patient organizations, physician groups, health plans, and other affected stakeholders.

Our work included:

1. Developing comprehensive comment letters and support materials that stakeholders could use to clearly articulate how important it was to preserve the measure, both for individuals with diabetes and for the Star Rating Program.
2. Coordinating key stakeholders’ engagement efforts to ensure policymakers heard a consistent message from multiple perspectives across the healthcare system.
3. Meeting with CMS, the US Department of Health and Human Services, the Office of Management and Budget, and multiple congressional offices to discuss the implications of eliminating the measure.

The outcome

When CMS released the final rule, the agency eliminated 11 of 12 Star Rating measures proposed for deletion, but retained the one screening measure of interest to our client.

For the healthcare services company, the decision preserved a critical business line and provided certainty for future planning. For Medicare beneficiaries, it preserved access to a vital screening service.

Merging strong policy arguments with effective engagement is the key to successful advocacy. That requires bringing together the right stakeholders, developing a compelling case, and reaching the right decision-makers quickly and effectively.

McDermott+ combines extensive policy skill with longstanding relationships across the healthcare industry, enabling clients to build broad-based support around complex policy issues. In this case, we helped mount a successful advocacy campaign that delivered meaningful results for our client and its stakeholders.