Strategies to Navigate Medicare’s Health Equity-Related Changes: Leveraging SDOH Member Data and Optimizing Star Ratings

Pricing: Free for Members and $30 for Non-Members

Course Description

Beginning with the measurement year 2024, Medicare will use social determinant of health (SDOH) data to adjust Star Ratings through the implementation of the Health Equity Index (HEI) and risk adjustment for adherence measures. These new features will meaningfully impact plan sponsors’ Star Rating scores and associated Quality Bonus Payments. As plans navigate Medicare’s health equity-related changes, it is critical to understand the design of these new incentives and how to adapt programs to respond to them. This session will provide a detailed look into the technical aspects of these changes and provide a practical perspective on collecting and integrating SDOH data into current data environments. Additionally, this session will include results from the development and application of a medication nonadherence SDOH score for use in targeting members at risk for SDOH-related nonadherence.

Target Audience

Pharmacists who practice in managed care settings.

Learning Objectives

At the completion of this activity, participants should be able to:

  1. Discuss technical aspects of the new Star Ratings Health Equity Index and adherence measure risk adjustment methods.
  2. Explain the practical and financial implications of Medicare’s health equity-related program changes.
  3. Understand how to collect essential social determinants of health data and incorporate these data into existing data environments.
  4. Describe the application of SDOH data to inform member targeting and optimize measure performance in the evolving Star Ratings landscape.
Course summary
Available credit: 
  • 1.25 ACPE
    ACPE The Academy of Managed Care Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.
  • 1.25 Certificate of Completion
Course opens: 
05/03/2024
Course expires: 
12/31/2025
Cost:
$30.00

Faculty

Lisa Lewerer
Client Quality Principal
Prime Therapeutics
Eagan, MN

Sujith Ramachandran, PhD
Associate Professor of Pharmacy Administration
The University of Mississippi School of Pharmacy
University, MS

Ben Urick, PharmD, PhD
Health Outcomes Research Senior Principal
Prime Therapeutics, LLC
Chapel Hill, NC

Moderator

Christopher Diehl, PharmD, MBA, BCACP
Director, Clinical Pharmacy Programs and Experiential Education
Excellus BCBS - Rochester, NY
Rochester, New York

 

Financial Relationship Disclosures

Faculty/Reviewer/Planner​

Reported Relevant Financial Relationships​

Ben Urick, PharmD, PhD​

Faculty​

Employee: Prime Therapeutics​

Lisa Lewerer​

Faculty​

Employee: Prime Therapeutics​

​

Sujith Ramachandran​

Faculty​

Consultant: Cencora; Consultant: Medtronic; Consultant: Pharmacy Quality Alliance; Consultant: Indegene​

Tracy McDowd​

Reviewer​

Disclosed no relevant financial relationships.​

Brooke Whittington​

Planner​

Disclosed no relevant financial relationships.​

​

  • If applicable, relevant financial relationships have been mitigated and documented.
  • Content has undergone a peer review to ensure content validity.

Accreditation:

The Academy of Managed Care Pharmacy (AMCP) is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

ACPE UAN: 0233-0000-24-019-H04-P • Activity Type: Knowledge-Based
Contact Hours: 1.25
Release Date: May 3, 2024 •  Expiration Date: December 31, 2025
Activity Fee: Free for Members and $30 for Non-Members

Participants should claim continuing pharmacy education (CPE) credit for this home study activity only if they have not claimed credit for the live activity presented at AMCP 2024. CPE credit will be processed through the AMCP Learn portal and reported directly to CPE Monitor. Please allow 72 hours for processing and posting in your NABP account.

To receive credit for an online activity you must:

  • Review the full content of the activity.
  • Successfully complete the post-test (required to pass with a score of 70% or higher, it may be taken a maximum of three times).
  • Complete a specific activity evaluation.

Available Credit

  • 1.25 ACPE
    ACPE The Academy of Managed Care Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.
  • 1.25 Certificate of Completion

Price

Cost:
$30.00
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Required Hardware/software

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 websites. View the minimum technical and system requirements for continuing education online learning activities