Unlocking Health Equity: A Strategic Framework for Success in the Health Equity Index Era of the Stars Program

In the ever-evolving landscape of the Medicare Stars program, the introduction of the Health Equity Index (HEI) in the CMS Final Rule of 2023 marks a pivotal moment in shaping the future of Medicare Advantage plans. Set to become a key determinant in Star Ratings from 2027 onward, the HEI presents a groundbreaking shift in focus—prioritizing health equity, recognizing social risk factors (SRFs) and urging plans to better serve underserved populations. 

As the industry prepares for this transformative change, ProspHire is at the forefront, introducing a comprehensive strategic framework for success. Comprising four essential pillars—Data and Analytics, Benefit Design, Member and Provider Engagement and Community Partnership—our approach is designed to empower health plans in navigating the nuances of the HEI landscape. We dive into the intricacies of the Health Equity Index, unraveling its objectives to enhance health equity, incentivize improved care for underserved communities and foster growth for plans aiming to extend their reach. Health plans must put focus on these four pillars to establish a strong foundation.

To access the key activities in ProspHire’s health equity strategic pillars please provide the information below and click on download now.