Education, advocacy key to success under new Quality Measures, expert says

Skilled nursing providers may have to “teach” industry stakeholders how recent changes to the Five-Star Quality Rating System have impacted their ratings in order to maintain successful network partnerships, one expert stressed on Monday.

While 11% of the skilled nursing sector gained a star under recent methodological changes to the rating system, another 16% lost a star, said Cheryl Field, chief product officer for Prime Care Technologies, citing American Health Care Association data. Field spoke during a session at AHCA's 67th Annual Convention & Expo in Nashville.

“You may be one of those providers who went from a three to a two,” Field said. “That hit hard.”

To stay in a referral network's good graces, Field urged providers whose ratings shifted under the new measures to utilize education and advocacy to show hospitals, accountable care organizations and other partners how the recent changes impacted their rating — and then back it up with current data.

“Get this out in front of them: We didn't change, the methodology changed,” Field said. “These guys have their money on the line. They just need current data that gives them confidence in you. There's no reason they can't include you in the network.”

An estimated 4,300 providers and exhibitors were expected to attend this year's AHCA/National Center for Assisted Living convention and expo at Nashville's Gaylord Opryland Resort and Convention Center. The convention continues through Wednesday.