Medicare Advantage star ratings play a significant role in the healthcare industry. They are among the top determinants of the quality and standards of the medical services provided by different healthcare centers. The grading system designed by the Centers for Medicare and Medicaid Services is useful in deciding the overall performance of the Medical Advantage programs. Looking at the past years’ records, the US healthcare insurance providers did undergo greater economical pressure due to excess consumption of services than estimated which led to an increase in medical-loss ratio. The social factors greatly impact Medicare Advantage plans and their star ratings. Let’s explore how social factors can be best used for improving medical services.
A Few Social Determinants Of Health
The surroundings in which people live, work, and spend their maximum time greatly affect their intrinsic well-being. The socio-economic factors have a significant impact on the health and the obsolete healthcare system is not well-equipped to focus on these factors. Lately, the evolution in fundamental breakdown is for the good. It involves the implementation of advanced, optimized care into the relationship between service providers, medical plans, and the authorizing personas. Listing below a few critical social determinants –
Access To Nutritional Food
Food insecurity is among the top social determinants of health of the individuals. The developed countries include approximately 4% to 7% of adults who experience hunger and lack proper nutritions. Besides, millions of adults live in the geographical, low-income areas which limits the access to grocery outlets and affordable food. Lack of nutritional food can noticeably impact the health conditions of older adults negatively. At the time of hospitalization, the older people often suffer from malnutrition due to lack of good quality food. The old-age people are often not able to recover due to the carelessness of medical aid providers. A poor quality of food-assistance even after getting admitted to the hospital disables the suffering individuals from executing routine activities efficiently and earning a living.
Accommodation And Transportation
Residing in rural areas makes it difficult for the old-age people to receive timely and standardized medical aid. To get good medical aid, they are generally required to move to distant cities. Lack of transportation hinders them from moving to the major cities for availing medical services. A survey was conducted in 2021 by ScienceDirect among 244 old age people. After the comparison between the adults who are not able to access quality healthcare aid and the ones living in urban areas with timely healthcare assistance and easy transportation the following observations were made –
- 135 applicants never availed medical services.
- 55 of them had family doctors.
- 54 used services by medical specialists.
- 10.6% of the total couldn’t show up for the appointment due to lack or expensive transportation.
The residents of rural areas lack proper and qualified medical assistance. They are not getting proper medical assistance due to accommodation issues. Besides, the individuals suffering from ailments require regular screening and dedicated treatments but due to the distance it becomes difficult for them to be present every time.
Health Literacy
There has been ample research that shows that health literacy significantly impacts the medical condition of adults. The individuals must have basic knowledge about blood sugar levels and blood pressure. Everyone must be literate enough to understand the common symptoms of the medical situation. The unawareness among the people leads to less usage of preventive medical facilities like vaccination, mammography, etc. The unaware individuals can’t look after themselves in case of unavailability of medical aid; for example – individuals suffering from asthma can’t use the inhaler correctly, and they can’t understand the prescription and medicine labels. Awareness regarding essential medical treatment and health conditions is critical to boost overall health.
Income Levels
Low-income families are generally seen suffering from poorer health conditions as compared to the ones earning a better income. The availability of quality medical treatment can be expensive. The people suffering from poverty and financial issues make a more significant addition to the victims of excessive smoking and obesity issues. The economic burden is even more critical for the people who do not have access to supplemental insurance support. People facing financial problems are more likely to miss out on efficient medical aid.
A Proper Addressal Of Social Determinants To Elevate Medical Advantage Star Ratings
From the above mentioned, it’s clear that the social and economical factors play a herculean role in determining the standards of health of a country on a whole. Below are a few steps that can be taken to improve the star ratings –
- Spreading Awareness – Organizing specific campaigns and conducting surveys to create awareness among the people can be good for educating them about medical conditions and healthcare services for them. Webinars, pamphlets, and preventive screening are good ways to create awareness among the people.
- Rewards And Incentives – Incentive programs and rewards strategies can be great for encouraging the members to avail of preventive screening. The rewards can include wellness discounts, gift cards, etc. to encourage members for regular health check-ups and consulting the specialists.
- Integrated Care Coordination – This involves specific data analytics tools that ensure the involvement of preventive screening and interventions to be incorporated into the routine.
Following these steps and taking similar actions creates awareness among the individuals regarding healthcare services and why it is important. It leads to an increase in the number of Medical Advantage plan seekers and increased usage of services. This can significantly improve the star ratings.
Conclusion
The socio-economic factors have a huge impact on the star ratings. The clinicals must take the responsibility to spread awareness about the importance of the same. Improve your Medicare Advantage Star Ratings 2024 by taking significant steps towards making people aware of your plans and how they can benefit from regular health check-ups.
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