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IL/IN Medicare Star Ratings for 2020

As a valued partner, I wanted to provide advance notice of a potential change to our overall Star Rating for our Illinois Medicare Advantage service lines. As you are well aware, Health Alliance is currently a 4 Star Rated plan (out of 5). We are very proud of the high quality services provided to our members. Recently we received a Star Rating preview, which indicates our rating may be declining to 3.5. In full transparency we wanted to provide a brief update of where we’ve been and plans moving forward.

Health Alliance began to see indications in late 2018 that our Star Ratings were beginning to show an unfavorable trend. As such, we completed a comprehensive gap analysis and identified areas in need of immediate attention to prevent impact to our 2019 rating. However, risks remained and significant efforts shifted to protecting our 2020 rating. Unfortunately, it was simply too late since Star Ratings are calculated from data two years prior. Ultimately, we may not realize the full impact of our re-dedicated efforts until the end of 2020.

Currently, we are reassessing our strategic plans based on these results and focusing on the following in an effort to recover our 4 Star Rating for 2021: breast cancer screening, diabetes measures, readmissions, medication therapy management, Health Outcomes Survey, and Consumer Assessment of Healthcare Providers and Systems. Readmissions and patient experience measures are of greatest concern due to heavier weights.

Our rating of 3.5 out of 5 Stars shows we are doing a lot of things right, but identifies some opportunities to improve. We’re taking this seriously, and continue to strive to become a 5 Star Rated plan. We will need ongoing and continued strong partner relationships and engaged teams to help us reach our goal.

Please feel free to reach out to me with any questions or if you have innovative solutions to improve our outcomes.

Future communication will be sent out via broker flash during the next several days with where to access and how to promote this 2020 Star Rating information.

Thank you.


April Vogelsang, RN, MS

System Senior Vice President & Chief Clinical Integration Officer

Health Alliance and Carle Health System