An inside look at how in-home visits are transforming quality improvement and Star Ratings performance by empowering health plans to close gaps and improve outcomes.
As every Medicare Advantage (MA) health plan knows: quality performance is more than a metric, it is a key driver of member outcomes, engagement and revenue. Medicare Advantage Star Ratings, which evaluate plans across categories such as staying healthy, managing chronic conditions, member satisfaction, complaints and customer service directly influence annual bonuses, enrollment growth and impacting health outcomes. Even modest improvements in these ratings can translate into meaningful operational and financial impact. Signify Health’s in-home visits provide a practical, data-driven approach to helping plans close quality gaps, improve member engagement and support improved clinical outcomes.
Addressing key barriers to quality performance
Closing gaps in care comes with many challenges for health plans. Fragmented data siloed across different providers and systems makes it difficult to get a complete view of a member’s care. Engaging members with different levels of health care literacy and balancing members’ communications preferences impact are important when conducting personalized outreach and implementing comprehensive quality improvement programs. Constantly evolving quality measures including HEDIS® and Star Ratings require continuous adaptation and investment.
One challenge is member turnover. With nearly 17% of MA members switching to original Medicare or another MA plan each year, plans are losing nearly one in five members before long-term member specific care plans can be completed or quality gains can be realized. That churn disrupts care coordination, fragments data continuity and increases acquisition and administrative costs which can negate months of quality improvement progress.
Gaps in preventive care and chronic condition management
Chronic conditions are common among older adults, with most managing at least one and many juggling two or more. Yet substantial gaps persist in preventive care. For example, approximately 70% of eligible adults miss colorectal cancer screenings, 61% of diabetes patients skip recommended kidney testing and diabetic retinopathy screenings are often overlooked. These missed opportunities can result in worsening health outcomes and higher costs for members and health plans.
How Signify Health in-home visits close gaps
Signify Health’s in-home visits provide time, attention and context that brief office visits cannot. Clinicians assess vital signs, review medications, screen for non-medical determinants of health and provide tailored education. Modular add-ons allow targeted diagnostics and screenings, including diabetic eye exams, hemoglobin A1c, kidney health tests (Urine Albumin-to-Creatinine Ratio (uACR), Estimated Glomerular Filtration Rate (eGFR) and Fecal Immunochemical Test (FIT) kits for colorectal cancer screening. Visits also reveal practical barriers including medication availability, fall risks, food insecurity and social isolation that can negatively impact adherence, comprehension and outcomes.
Signify Health’s visits are tailored to member needs: In-Home Health Evaluations focus on disengaged or chronically ill members and standalone Quality-Focused Visits address specific gaps for engaged members. Post-visit care coordination ensures results, documentation and follow-up recommendations reach PCPs and health plan care teams which help to translate insights into individualized care plans.
Proven impact on quality measures
Signify Health’s Quality Focused Visits have measurable effects on HEDIS® measures and MA Star Ratings. Across visits, 58% of HEDIS® measures are impacted, diabetic eye exam completion rates reach 97% and FIT kit return rates are 43%.* By providing flexible, modular and data-rich visits, Signify Health clinicians help plans engage members, deliver preventive services and drive measurable improvements in clinical and quality metrics.
Driving value for health plans
In-home visits improve quality metrics and deliver tangible value to health plans. Higher Star Ratings generate annual bonuses and support enrollment growth. By bridging gaps in care, expanding member reach and enhancing engagement, Signify Health positions plans to optimize resources while achieving clinical and financial goals.
Turning insights into action
Signify Health’s in-home visits combine clinical expertise, modular screening tools and targeted care coordination to help health plans close quality gaps, drive member engagement and ultimately, improve Star Ratings. By addressing barriers that limit preventive care and chronic condition management, these visits empower members and support sustainable outcomes delivering quality and value in equal measure.
*Signify Health. Data on file.