Integrated, Data-Driven Approaches for Successful Star Ratings Strategies

ACPE UAN #:   0233-0000-16-011-H04-P

Release Date:  Wednesday, April 20, 2016

Expiration Date:   Wednesday, April 20, 2019

Activity Type:  Knowledge-based  

Contact Hours:   1.25

Activity Fee:  Member:  $15.00             Non-Member:  $30.00


As an accredited provider, AMCP strictly adheres to the ACPE Standards for Commercial Support and other relevant guidelines and standards to ensure the independence of continuing pharmacy education (CPE) activities.  It is AMCP’s intent that all CPE activities be independent, objective, balanced, evidence-based and free of any commercial bias.   

Target Audience: This repurposed session from the AMCP Annual Meeting 2016 is designed to provide insights and solutions for pharmacists who practice in managed care settings, to help them maintain and enhance their knowledge, skills, and abilities. 

Activity Overview

Staying ahead of the complex health care challenges facing the industry requires innovation and optimization of quality in all areas of care. Medicare Part D Plans especially can’t leave their quality ratings strategies to chance, given the removal of predetermined 4-Star thresholds, a heavy flow of Health care Effectiveness Data and Information Set (HEDIS) mandates coming from the Centers for Medicare & Medicaid Services (CMS) Star Ratings, and continued movement towards value-based reimbursement models. Now more than ever, smart plans maximize their efforts by taking an integrated, data driven approach across multiple channels, including medical and pharmacy. Plans are also tying quality to performance by “pulling all levers” with their provider and pharmacy strategies.

This session will highlight best practices in designing data-driven strategies. The speakers will share recent successes in implementing one of the first and largest pharmacy quality network pay-for-performance programs to help improve member outcomes. 

Learning Objectives:  

  1. Discuss the key 2016 Centers for Medicare & Medicaid Services (CMS) Star Ratings landscape changes and how they are impacting Medicare plan strategies.
  2. Explain the three ways data can and should be used to design a Star Ratings strategy.
  3. Summarize how Medicare Part D Plans can effectively leverage retail pharmacy “pay for value” strategies to drive improved patient outcomes.

Schedule of Educational Activity

This CPE online activity consists of a pre-recorded audio/slide presentation, a pre-test (to establish prior knowledge, not required to pass), a post-test with a score of 70% or higher, and a specific online activity evaluation. 

Faculty Relevant Financial Relationships Disclosure: AMCP asks everyone who is in a position to control the content of a continuing pharmacy education activity to disclose all relevant financial relationships with commercial interests. If AMCP determines that a conflict of interest exists as a result of a financial relationship you have (or that your spouse/partner has), we will need to take appropriate steps to resolve the conflict of interest.

  • Sharon K. Jhawar, PharmD, MBA, CGP reports having no financial relationships with any commercial interests during the past 12 months.
  • Rebecca Rabbitt, MS, PharmD reports having no financial relationships with any commercial interests during the past 12 months.
  • AMCP staff report no relevant financial relationships pertinent to this activity: Puneet Singh, PharmD and Ruby Singh, PharmD, BCPS.

Method and CPE Requirements:   

Participants should claim continuing pharmacy education (CPE) credit for this online activity, only if they have not claimed credit for the live activity presented at the AMCP Annual Meeting 2016. 

CPE credit will be processed through the AMCP Learn portal and reported directly to CPE Monitor.  Please allow 24-72 hours for processing and posting in your NABP account.

To receive CPE credit for an AMCP Learn online activity you must:

  • View the entire pre-recorded audio/slide presentation.
  • Successfully complete the post-test with a score of 70% or higher (The post-test will provide feedback.)
  • Complete a specific online activity evaluation.

System Technical Requirements/Viewing Requirements: System Requirements Courses and learning activities are delivered via your Web browser and Acrobat PDF. For all activities you should have a basic comfort level using a computer and navigating the web site.  View the minimum technical and system requirements for online educational activities.


Credit Information

Activity Number Credit Amount Accreditation Period
ACPE UAN #0233-0000-16-011-H04-P 1.25 Contact Hours April 20, 2016 - April 20, 2019