Achieving New Heights with CMR Rates

As CMS pushes Medicare Part D completion rates to new heights, our team at Clinical Support Services is bringing innovations to meet the challenge. Over the past 18 years, our Clinical Outreach Center has completed hundreds of thousands of CMRs. We are helping our partners achieve five-star ratings and the highest completion rates across the country.

Based on August’s Medicare 2019 Part C & D Star Ratings technical notes from CMS, the CMR 5-Star rating projects to be +85% completion. This increase will go well beyond calling. Our team has mastered the art the conversational CMR from talking about a hometown sports team to the fall foliage, and we know there are portions of the population that require different engagement techniques.

Our goal is to engage with every member in their preferred method of communication. With that in mind, we have deployed many new ways to connect with the member to help accelerate the number of CMRs completed each month. We aim to not only increase the number of CMRs completed but also to accelerate the completion rates.

CSS MDLink Technology: Coordinate provider referrals to the MTM program through integrated communication portal. MDLink is a system of referral generation and coordination for services which have not traditionally required a referral.

Second Welcome Letter: Send a second welcome letter to remaining MTM eligible members to stress the importance of participation in the MTM program.

Diversion of Declines & Potential Opt-outs: Divert the CMR declines and potential opt-outs to the provider for coordination and scheduling. The AMCP MTM committee supports the tactics and has recommended the change to CMS.

Premium data correction services: Leverage third-party data sources to correct phone numbers for members remaining in our uncontacted population.

SMS Text Messages: Leveraging our call center technology, we can reach out to targeted members for CMR scheduling and coordination. The SMS outreach is approved in coordination with health plan guidelines.

Contact Pharmacies & Providers for Contact Information: Reach out directly to the most recent pharmacy and primary care physician for updated contact information both phone and mailing address.  

 

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