Health Plans are working harder than ever to secure government reimbursements.

VSP® Vision Care can help you understand HEDIS Measures and how they aff ect your Star Ratings.

Star Ratings: How to Maximize Reimbursements

Star Ratings OverviewEach year, The Centers for Medicare and Medicaid Services (CMS) conduct a comprehensive review of measures that make up the Star Ratings.

What this meansWith regular changes to rating criteria, Health Plans will have to work harder than ever to win reimbursements; however, improving your Star Ratings may be easier than you think.

VSP can helpWith the complimentary VSP Eye Health Management Program® VSP helps you improve your HEDIS Scores and Star Ratings in three easy steps:

1

3

2

Identify

Share

Engage

With chronic conditions like diabetes increasing, early detection is more important than ever. We help you identify chronic conditions before costly symptoms emerge.

1. Human Capital Management Services, Inc. (HCMS) on behalf of VSP, 20132. National Center for Chronic Disease Prevention and Health Promotion, Center for Disease Control (CDC); 20123. Institute for Alternative Futures; http://www.pophealthmetrics.com/content/8/1/29 and American Journal of Preventive Medicine 2012

IdentifyFirst, we help you identify signs of chronic conditions earlier.Every WellVision Exam® includes a diabetic retinal exam. During this comprehensive eye exam, VSP doctors are the first to detect early signs of diabetes 34% of the time.1

2025 Forecasted Percentage of Diagnosed Diabetes in U.S.3

U.S. Percentage of Diagnosed Diabetes2

<6% 6-7% 8-9% 10-11% 12-13% 14-15% 16-17% 18-19%

34%OF THE TIMEVSP doctors are the first to detect early signs of diabetes.12025 Forecasted Percentage

of Diagnosed Diabetes in U.S.3U.S. Percentage

of Diagnosed Diabetes2

<6% 6-7% 8-9% 10-11% 12-13% 14-15% 16-17% 18-19%

1

ShareThen we collect and share key patient data.

VSP collects HIPAA-compliant patient condition data and diagnosis codes for:

diabetes

diabetic retinopathy

hypertension

high cholesterol

glaucoma, and

macular degeneration.

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You can also use our Medical Data Collection Report to proactively manage your members’ health.

EngageWe engage diabetic members with complimentary exam reminder letters.

At no cost to you, we send an exam reminder letter to VSP members identified as having diabetes if they haven’t had an eye exam within their eligibility period.

3

22%MORE OF THESE

MEMBERSreturn for an eye exam, giving

you more opportunities to engage members who have diabetes with your disease

management pathway.1

1. Human Capital Management Services, Inc. (HCMS) on behalf of VSP utilization data, 2013

Powerful Direct and Indirect SupportA low cost vision plan from VSP influences key HEDIS measures and both direct and indirect Star Ratings measures.

HEDIS Measures• Comprehensive diabetes care:

Ages 18-75

• Preventive care for seniors

Star Ratings Direct Measures• Diabetes care, eye exam

Star Indirect Measures• Reducing the risk of falling

• Improving or maintainingphysical/mental health

• Monitoring physical activity

• Care for older adults, functional status assessment

What do Health Plans Say?

*Over a one year period.

Prior to receiving VSP data, our baseline for identifying diabetic patients who regularly received their eye exams was 25%. A goal of 40% was set when we began working with VSP to receive vision data. Over a two-year period, they came in at 90%.

– Regional health system, Ohio

Our dilated eye exam rates for Medicare went up from 71% to 76%.*

– Health plan serving 150,000 members, Northern California

…HEDIS score increase of 18% for diabetic retinal exams…

– Health plan serving 150,000 members, Oregon

©2016 Vision Service Plan. All rights reserved. VSP, VSP Eye Health Management Program, and WellVision Exam are registered trademarks of Vision Service Plan. 7051 VCCL

A Better Vision PartnerWith regular updates to Star Ratings, health plans have to work harder to gain reimbursements. It’s more important than ever to get the most out of your partnerships.

Let VSP help you improve your competitive advantage, while increasing your HEDIS Scores, Star Ratings, and reimbursements.

Visit vspimproves.com to learn more.