Medicare Advantage, RPM & Star Ratings: Elevate Plan Performance by Impacting SDoH

80-90% of health outcomes are determined by non-medical, social factors. 
Providing value-based, member-centric care to address Social Determinants of Health (SDoH)
- via remote health monitoring services - can mitigate adverse impact to patients, and may help 
to ensure Medicare Advantage plan success.

These days, Medicare Advantage plans face many challenges, chief among them is how to address Social Determinants of Health (SDoH), boost MA plan performance, and help improve the delivery of care?

Defined more broadly, SDoH are the conditions in which people are born, grow, work, live and age – and can include a wider set of forces and systems that shape daily life (like socialization obstacles, food insecurity, poverty, and lack of convenient transportation).

All of this can contribute to, and even exacerbate, chronic health conditions and generate higher healthcare costs for populations that are already socially and economically challenged.

But what if there was a way that the supplemental benefits of Medicare Advantage plans could assist in proactively addressing SDoH and improving member well-being, all while boosting MA plans’ performance and Star Ratings?

Enter connected healthcare solutions, like Remote Patient Monitoring (RPM) and Personal Emergency Response Systems (PERS).

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Not only can Medicare Advantage plans improve rankings (HEDIS, CMS Star Ratings, CAHPS survey scores) by providing non-primarily-health-related benefits (non-PHRB) to eligible plan members and enrollees with chronic conditions, social needs, and functional needs, but offering these healthcare solutions can also enable proactive care management that unlocks powerful insights into addressing SDoH risks.

Clear Arch Health RPM/PERS Solutions Help to Unlock the Full Potential of Medicare Advantage Plan Benefits

4 Ways to Connect Medicare Advantage with RPM to Address Social Determinants of Health

  1. Build a Value-Based, Member-Centric Care Model
    Collaborate with Home and Community Based Services (HCBS) to deploy scalable solutions and leverage insights from RPM/PERS data for effective, prompt and responsive interventions.

  2. Identify SDoH-Impacted Medicare Advantage Plan Members
    RPM and PERS data can reveal hidden vulnerabilities, like social isolation or transportation limitations. Use this actionable intelligence to create services that can be tailored to suit specific patient needs. Doing so may help to enhance CMS Star Ratings for MA plans.  

  3. Embrace In-Home Healthcare and Home Health Services
    Home-based health services (see below) can help improve quality of care through access to programs that can directly impact social determinants of health.
  4. Offer a Range of Value-Based Benefits at the Point of Care
    Differentiate your health care plan by offering coverage for benefits like meals, transportation, fitness programs, PERS, RPM, hearing aids, personal care, and companion services. Utilize technology to deliver care and capture member data to personalize care, foster engagement, improve the overall health of the patient population, reduce hospitalizations/readmissions, and drive down healthcare costs.

Connected health devices, such as interactive RPM platforms and systems, 
act as a window into the “black box” of a member’s home. 
This helps care teams to better understand patients’ needs (static and changing).  
Additionally, personal emergency response systems (PERS) can offer 
unparalleled access to responsive care at the push of a button.

Clear Arch Health: Your Partner in SDoH-Focused Medicare Advantage

With over 20 years of experience in virtual healthcare solutions (as a division of PERS industry leader, MobileHelp), and extensive expertise providing multi-modality RPM solutions that have positively impacted over one million lives, Clear Arch Health can help your health plan:

  • Develop a comprehensive SDoH strategy:
    Our suite of value-based services (PERS, RPM, personalized customer support) directly address SDoH.
  • Leverage data and technology:
    We provide the tools that give you the insight to analyze member data, personalize care, optimize service delivery, and improve outcomes.
  • Enhance member experience:
    We partner to help create a more compassionate, member-centered care model that increases patient engagement and satisfaction.
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Ready to take your Medicare Advantage plan to the next level?

Contact Clear Arch Health today and let’s begin the conversation. Or, call us for a no-obligation demo, at your convenience.

Let’s talk about the Clear Arch Health Difference in RPM and PERS solutions for Medicare Advantage plans.

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