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<h3>Press Release</h3>FOR IMMEDIATE RELEASE<h3>Town Square Launches New Stars Medication&nbsp;Program to Improve Medication Adherence and Prevent Adverse Drug Events in Medicare Advantage Plans</h3>New tech-enabled, evidence-based initiative proven to improve health outcomes, reduce emergency department visits, and lower hospital readmissions for older adults.[New York, NY] — Nov 19, 2024 — Town Square is proud to announce the launch of a new program, Stars Medication, designed to help Medicare Advantage plans improve medication adherence and prevent Adverse Drug Events (ADEs) among their members. This innovative offering aims to reduce costly healthcare utilization and improve overall health outcomes for seniors, especially those managing chronic conditions like hypertension, diabetes, and cardiovascular disease.Medication non-adherence is a significant issue in the United States, leading to increased mortality, frequent emergency department visits, hospital readmissions, and a lower quality of life for millions of Americans. Disparities in adherence also exist based on gender and race, compounding the challenges. &nbsp;Medication errors contribute to more than 1 million emergency department visits each year, and drug-related morbidity and mortality cost the U.S. healthcare system more than $528 billion annually.1&nbsp; Research shows that 30-66% of community-dwelling older adults experience medication-related issues, many of which are preventable.2Additionally, CMS Star measures associated with medication are triple-weighted, and together they determine approximately one-third of a plan’s overall Star rating. These ratings have large financial implications for health plans, determining Star bonus revenue that plans can use to enrich benefits and attract more members. 3Town Square’s Stars Medication program is a solution that combines cutting-edge technology with hands-on support from Community Health Workers (CHWs) to address these challenges head-on. The technology enables CHWs to conduct in-home assessments to screen for fall risks, conduct medication inventory, assess medication use, and identify hazardous drug interactions. Working in collaboration with contracted pharmacists, the platform screens for potential adverse effects common in the senior population and sends medication change recommendations directly to the primary care physician and care team.&nbsp;<blockquote>With millions of older adults struggling to manage their medications correctly, we are excited to offer a comprehensive, evidence-based solution that directly addresses medication-related problems that put lives at risk," said Royal Tuthill, Founder &amp; CEO of Town Square.&nbsp;</blockquote>The Stars Medication program works to reduce these risks and prevent adverse outcomes, improving health plan ratings and driving meaningful financial incentives for health plans.<h3>Program features include:</h3><ul><li>In-Home Medication Risk Assessment: Comprehensive evaluation of medication use, reviewed by pharmacists, to identify and address medication-related problems.</li><li>Fall Risk and Health Risk Assessments: Home environment assessments and collection of Social Determinants of Health (SDOH) data to better understand and address the broader health needs of members.</li><li>Medication Adherence Support: Enrollment in mail-delivery pharmacy services to help members manage their medications more effectively and reduce barriers to adherence.</li><li>Primary Care and Wellness Visit Support: Assistance with finding a Primary Care Physician (PCP) and scheduling Annual Wellness Visits (AWVs) to ensure holistic care.</li></ul><figure id="figure-92t77pc27jm3oraics"><img id="92t77pc27jm3oraics" src="https://cdn.durable.co/blocks/2aTrXqhxLQEHMmsC8rFBEZBFrgwUvf7QKdX97GCbY5dhA3lQRo3ZOe28BQFHLcpa.png" alt="Graphic showing the early results of Town Square's Stars Medication Program" title="Graphic showing the early results of Town Square's Stars Medication Program" class="object-cover bg-gray-100 rounded-sm md:rounded-md lg:rounded-lg" style="aspect-ratio: 16/9; object-position: center center;" data-corners="default" data-aspect="16:9" data-caption="" data-positionx="undefined" data-positiony="undefined" data-fullwidth="false" data-mce-src="https://cdn.durable.co/blocks/2aTrXqhxLQEHMmsC8rFBEZBFrgwUvf7QKdX97GCbY5dhA3lQRo3ZOe28BQFHLcpa.png" data-mce-style="aspect-ratio: 16/9; object-position: center center;"></figure><h3>Proven Health Outcomes:</h3>Early results from the program have shown significant success in improving health outcomes and reducing the high costs associated with medication-related issues:<ul><li>12.8% reduction in emergency department visits</li><li>22% reduction in hospital readmissions.</li><li>84% patient acceptance rate with participants agreeing to and completing assessments.</li></ul><h3>Stars Impact</h3>The Stars Medication program contributes to successful quality medication adherence and polypharmacy measures including:<ul style="list-style-type: square;" data-mce-style="list-style-type: square;"><li>&nbsp;Polypharmacy Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH)</li><li>&nbsp;Polypharmacy Use of Multiple Central Nervous System Active Medications in Older Adults (Poly-CNS) </li><li>Concurrent Use of Opioids and Benzodiazepines (COB)</li><li>Statin Therapy for Patients with Cardiovascular Disease</li><li>Controlling High Blood Pressure</li><li>Diabetes Care – Blood Sugar Controlled </li></ul><h3>About Town Square:</h3>Town Square is a leading provider of technology to support virtual and in-home Community Health Worker services, focused on improving the health and wellbeing of seniors through personalized care and support. Through a combination of technology and in-person care, Town Square helps health plans, providers, and communities achieve better health outcomes, reduce healthcare costs, and enhance the overall quality of life for older adults.Making whole person health a reality in every community.For more information about Town Square’s Stars Medication program or to learn more about our other &nbsp;comprehensive virtual and in-home CHW services, please contact us at:Town Square &nbsp;Email: info@jointwonsquare.comWebsite: <a data-mce-href="jointownsquare.com" href="jointownsquare.com">jointownsquare.com</a>****************Sources:(1) JAMA. 2013;309(3):267-274. doi:10.1001/jama.2012.173925 &nbsp;January 16, 2013 Association Between Medicare Advantage Plan Star Ratings and Enrollment. &nbsp;Rachel O. Reid, MS; Partha Deb, PhD; Benjamin L. Howell, PhD; William H. Shrank, MD, MSHS(2) NIH. 2018 Sep;52(9):829-837. doi: 10.1177/1060028018765159. Epub 2018 Mar 26. Cost of Prescription Drug-Related Morbidity and Mortality. Jonathan H Watanabe, Terry McInnis, Jan D Hirsch(3) NIH. Medication Management of the Community-Dwelling Older Adult. Karen Dorman Marek; Lisa Antle.

New From Town Square: Stars Medication Program

Town Square's mission is to revolutionize the way vulnerable populations access social care, by creating a connected ecosystem of healthcare and social care organizations to make whole person health a reality in every community.Town Square provides cost-effective, turn-key social care coordination for members with health-related social needs. By leveraging the existing support of your local community, Town Square programs improve member engagement, screen for and meet social needs, and close targeted gaps in care.&nbsp;Health plans improve quality and member health. CBOs benefit from sustainable partnerships with aligned incentives.&nbsp;While SDOH programs are better understood in 2024 than they were a few short years ago, they are still often perceived as a significant cost center with loose correlation to reductions in total cost of care and only relevant for a small number of the highest risk members.&nbsp;<a data-mce-href="https://jointownsquare.com/blog/is-sdoh-the-key-to-unlocking-ma-profitability" href="https://jointownsquare.com/blog/is-sdoh-the-key-to-unlocking-ma-profitability" target="_blank" rel="noopener">Town Square has a different perspective.</a> Today, we dive into frequently asked questions in the social care space to better illuminate new opportunities and misconceptions related to SDOH.<h3>What is the biggest misconception of SDOH?</h3>Our lens is too narrow. I think SDOH is often still framed as a handout for niche populations. Last year, 43% of all Americans had at least one unmet social need. 68% of seniors had unmet social needs. 72% of Americans lack retirement savings. 52% of employees have one or both parents living with them (up from 38% in 2000). Food prices are up. Gas and transportation prices are up. Interest rates are high and wages are stagnant. This climate is putting tremendous pressure on Americans, especially seniors, forcing them to make trade offs that negatively impact their health. &nbsp;We have to start with the understanding that SDOH needs are very, very prevalent.&nbsp;Thinking about SDOH as a “total cost of care” issue narrows our understanding of its potential – social care is a formidable lever to drive consumer loyalty, engagement and growth, as well as health and equity. Being there and helping to solve a member's social needs during their most vulnerable moments is a very powerful opportunity to build trust and loyalty, and better health.<h3>How has the adoption of SDOH in Medicare Advantage changed over time?</h3>Over half of eligible Medicare beneficiaries now have Medicare Advantage (MA). A large part of MA’s growth has been attributed to low cost health benefits and a growing number of supplemental benefits including vision, dental, gym membership, an OTC card, etc.&nbsp;However, given the current reimbursement rates, many plans are publicly stating they intend to pull back on benefits. At the same time, consumer demand for social care supports is higher than ever. Furthermore, CMS has initiated a new Health Equity Index bonus payment starting in 2025 that will swing Star ratings by up to 0.4 points. For the first time, a significant portion of a health plan’s Star Rating will be driven by their performance among members who have social risk factors.With high competition for member growth and retention, savvy health plan leaders will take the opportunity to recalibrate to this new market. The second wave of growth in MA will be driven by more personalization and tailored social service support.<h3>What are the challenges for insurers in deploying these expanded services?</h3>The expansion of tailored SDOH services and social care coordination creates administrative challenges for insurers. As they add more services, the complexity of delivering them also increases.&nbsp;For elderly individuals, chronic conditions and social needs like income, health status and living situations can change quickly, so plans need to have a regular, trusted connection to their members. But it is not cost-effective for plans to use their traditional care management team to scale SDOH services.&nbsp;At the same time, because social services are often delivered locally, health plans would have to manage a significantly larger fragmented network of vendors and social care organizations. This is especially a challenge for regional and mid-sized plans. Scaling these operations will require investment, but not making the investment will leave them further behind the competition as members find the support they need elsewhere.<h3>How is Town Square working to solve these challenges? </h3>We are bringing to market a turn-key solution for health plans that lowers administrative costs to deploy social care coordination while improving member experience, retention and health outcomes.&nbsp;Town Square provides wrap-around services and technology to help facilitate partnerships between community based organizations and healthcare organizations.&nbsp;Our local teams of tech-enabled Community Health Workers forge longitudinal relationships with members, building trust and reciprocity by leading with social care. They screen member social needs, guided closed-loop referrals, and close targeted care gaps, driving member satisfaction and health outcomes. We also build networks of high-performing social care networks tailored to member and market needs that are managed by our team and paid for performance, ensuring services are delivered. Our technology enables us to streamline processes, increase efficiency and standardize member-level SDOH data for greater visibility into performance and gaps in services, and to meet compliance reporting needs.<h3>Closing Thoughts</h3>Imagine being an elderly individual, having lived a life full of hard work and contribution. Age brings challenges like loneliness, chronic illness and home maintenance issues, but a health plan designed for seniors can change that. We create a support system that honors the unique journeys of our seniors and lets them know that their well-being truly matters. In-network social service organizations become companions, bringing warmth and assistance. They deliver meals, ease grocery shopping, and maintain homes – lifting burdens and breaking isolation. The impact is profound. Mobility is regained, outings are possible and safe homes offer security. Coordinated social care isn't just health services, it also restores dignity, enabling seniors to live and age more gracefully.&nbsp;<h3><a data-mce-href="https://jointownsquare.com/contact-us" href="https://jointownsquare.com/contact-us" target="_blank" data-mce-selected="inline-boundary">Contact us</a> to more about how Town Square can support your plan and the communities you serve.&nbsp;</h3>

SDOH: An Untapped Profit Center

Executive Takeaway: The recent financial pressure on Medicare Advantage businesses means plans must focus on ways to improve retention, maintain Star Ratings, and meet new regulatory changes. The good news is - new SDOH programs — such as Town Square — may be the key to all three. To learn more about how Town Square can support your organization, email us at info@jointownsquare.com. We’ve all seen the headlines; the Medicare Advantage market is under pressure. Humana’s CEO Bruce Broussard articulated the current environment well, "the Medicare Advantage sector is navigating a complex and dynamic period of change as we are all working through significant regulatory changes while also absorbing unprecedented increases in medical cost trends.”Profitability and meeting new regulatory requirements are top of mind for health plan leaders. Here’s why investments in new SDOH programs may be the key to unlocking both, and how Town Square can support leaders to meet their goals.<h3>How New SDOH Programs Drive Retention &amp; Profitability </h3>It's the Medicare Advantage Open Enrollment Period (OEP), and many executives are closely watching their retention rates. The average annual voluntary disenrollment rate is around 20%, and the cost to continually replace lost members is financially unsustainable. The cost to acquire new members keeps going up and typically plans don’t make a profit on Medicare beneficiaries until the third membership year. Focusing on member retention is critical to profitability and SDOH programs can be a key mechanism to increase retention.The case for SDOH programs and retention:&nbsp;• Supporting a member to overcome their most vulnerable moments in life can differentiate your relationship and increase year-over-year member retention. &nbsp;Imagine if this were your member: “I didn’t think I could stay at home anymore until my community guide Maria helped me get rides to my doctor and meals delivered. She even helped me get pest control service when we needed help. Now I feel I can stay at home close to my family. It changed my life!”• An important demographic shift is the increase in unmet social needs among the senior population. Due to rising food, gas, rent, and other basic necessities, 68% of seniors are now experiencing gaps in social care or Social Determinants of Health (SDOH). Consumer demand for SDOH support is so high that members often put their SDOH needs first, and their health often takes a backseat. For innovative health plans this creates a new opportunity to meet members social needs and win member loyalty.&nbsp; Smart investments in SDOH programs with an SDOH network and member engagement platform like Town Square make it seamless to operationalize these programs and provide direct impact to plan profitability. Here’s how: • Helps retain members through the critical three year profitability period • Ensures members are known to the plans, receive accurate health risk assessments and are utilizing appropriate benefits • Connects members with critical upstream SDOH support that can help reduce, prevent, or delay costly medical spending and even prolong their ability to live at home • Builds trust and enhances our influence over member behavior to drive other healthy actions like closing care gaps and regular PCP visits All of these efforts lead to improved member satisfaction and experience. <h3>How SDOH Impacts Star Ratings and CMS Penalties</h3>Member Satisfaction: In 2020, CMS began making changes to Star ratings, giving substantially more weight to customer experience metrics than in the past. Given the growing consumer demand for social service support, meeting and exceeding members expectations by supporting their unmet social needs is a great way to improve satisfaction.Health Equity Index: The recent inclusion of a Health Equity Index (HEI) to the Star Ratings methodology is a major change to star ratings methodology for MA plans. The HEI will replace the existing reward factors for Quality Bonus Payment (QBP) and reward contracts serving members with social risk factors (SRF). Failure to have enough enrollees with SRF and to sufficiently serve these populations can reduce a plans Star Rating. If plans want to retain their bonus payments and Star ratings, smart investments in SDOH will be critical.Further, once plans have grown the pool of members with social risk factors they’ll need to cost-effectively meet their needs to ensure they stay in a mid-risk tier and don’t escalate to high cost / higher risk levels. And, it is financially advantageous to build trust and retention with a population of members that have moderate risk scores and are well managed.Part C Reporting Requirements: Starting this year, January 2024, plans are now required to communicate to members the balance of their unutilized benefits. Health plans have historically struggled with low engagement rates and high costs when communicating with members with social risk factors. Many plans will benefit from working with vendors like Town Square that offer tech-enabled member engagement services that can cost effectively support members and facilitate these types of screenings and benefit utilization communications.&nbsp;<h3>SDOH Made Easy with Town Square </h3>We created Town Square to help Medicare Advantage plans stay ahead of the curve. All of the initiatives above are not siloed programs, they are components of a holistic approach to supporting the 68% of seniors who have unmet social needs, with trust and empathy.&nbsp;Town Square’s innovative end-to-end SDOH network and engagement platform enables health plans and social service organizations to work together seamlessly and &nbsp;wrap-around member engagement services from local Community Guides to scale relationships with members and guide them to the right social services when they need it most.Through aligned incentives, innovative technology and human trust, we’re helping plan leaders improve financial performance and the health of their members.To learn more about how Town Square can support your organization, email us at <a href="mailto:info@jointownsquare.com" data-mce-href="mailto:info@jointownsquare.com">info@jointownsquare.com</a>

Is SDOH the Key to Unlocking MA Profitability?

The Centers for Medicare and Medicaid Services (CMS) has made notable changes in their Medicare Star Ratings methodology and emphasized health equity and social determinants of health (SDOH). Milliman recently published an article outlining the full 2025 Star Rating changes and proposed plan 2025 bid recommendations. Most pointedly, Milliman noted Medicare Advantage plans must prioritize health equity in order to maintain their Star Ratings. The most recent changes signal CMS’s commitment and continued investment in health equity and member experience as well as increased marketing and risk adjustment oversight.&nbsp;Here's a summary of what you need to know.<figure id="figure-swg2oc2sgdlrl77r68"><img id="swg2oc2sgdlrl77r68" src="https://cdn.durable.co/blocks/20m6HPKoPNl9mL69z9V9FYqmk2HSKZLlbPMBHhCGhnrFB8vnqTgIExrJBHyymQvE.jpg" alt="" class="object-cover bg-gray-100 rounded-sm md:rounded-md lg:rounded-lg" style="aspect-ratio: 16/9; object-position: undefined undefined;" data-corners="default" data-aspect="16:9" data-caption="" data-positionx="undefined" data-positiony="undefined" data-mce-src="https://cdn.durable.co/blocks/20m6HPKoPNl9mL69z9V9FYqmk2HSKZLlbPMBHhCGhnrFB8vnqTgIExrJBHyymQvE.jpg" data-mce-style="aspect-ratio: 16/9; object-position: undefined undefined;"></figure> <h2>Key Impacts </h2> <h3>• Financial Implications</h3>Overall, the 2025 methodology changes are anticipated to reduce MA Plan revenue, especially for contracts with 3.5-, 4.0-, and 4.5-Star Ratings. CMS estimates around $2.3 billion in cost savings by 2028 with potential increases if certain rule changes are finalized. Lower Stars Rating impact Medicare Advantage bonuses limiting the funds plans are able to reinvest back into plan including supplemental benefits. <h3>• 2024 Final Rule Changes</h3>CMS announced changes in the 2024 Final Rule, including the removal of the 60% rule, introducing the Health Equity Index (HEI) rewards system, and reducing patient experience and access measure weights. These changes may significantly affect MA plans financially. <h3>• Removal 60% Rule (Disaster Adjustment)</h3>CMS removed the disaster adjustment (60% rule) applied during the COVID-19 pandemic. This change means plans can no longer apply the disaster adjustment universally and cannot take the best of their measure scores from the current or prior years. As a result, plans will need to perform well on measures during the reporting period as historic performance will no longer be taken into account.&nbsp; <h3>• Tukey Outlier Removal</h3>&nbsp;In 2024 CMS removed Tukey outliers in cut point calculations and will now compare every plan against each other. On the heels of Tukey <a data-mce-href="https://www.healthscape.com/insights/2024-star-rating-analysis-beyond-the-outliers/#:~:text=This%20year%20was%20marked%20by,points%20to%20a%20higher%20range." href="https://www.healthscape.com/insights/2024-star-rating-analysis-beyond-the-outliers/#:~:text=This%20year%20was%20marked%20by,points%20to%20a%20higher%20range.">outlier removal</a>, MA Star Ratings were impacted as plans had to perform better on individual Star measures, increasing the threshold for 4 and 5 Star plans. Moreover, a Health Scape 2024 Star Rating analysis noted Tukey was a factor in plan performance and noted increases in individual measure performance did not always translate in Stars improvement, meaning plans need to perform even better to meet Stars measurements. <h3>• Health Equity Index (HEI)</h3>The HEI will replace the existing reward factors for Quality Bonus Payment (QBP) and reward contracts serving low-income, dual-eligible, and disabled populations, or social risk factor (SRF) populations. Failure to have enough enrollees with SRF and to sufficiently serve these populations may potentially reduce <a data-mce-href="https://www.milliman.com/-/media/milliman/pdfs/2023-articles/10-6-23_medicare-star-ratings-white-paper_20231005.ashx" href="https://www.milliman.com/-/media/milliman/pdfs/2023-articles/10-6-23_medicare-star-ratings-white-paper_20231005.ashx" target="_blank" rel="noopener">Star Ratings</a>. The change is estimated to result in program savings of $670 million in 2028, increasing to $1.05 billion in 2033. More so, CMS expects 75% of the total 5.0-Star contracts would shift to 4.5-Stars and lose the marketing and enrollment advantages of being 5.0-Star when the reward system moves to the Health Equity Index (HEI).&nbsp;<figure id="figure-uo4uzesdtqlrqf7jzp"><img id="uo4uzesdtqlrqf7jzp" src="https://cdn.durable.co/blocks/1oNHpsZyfxrzp0jZHDl95vYefSYYGiP9WdQCP31x8Cuk5tmziUd4S6WgwZa1v7jm.jpg" alt="" class="object-cover bg-gray-100 rounded-sm md:rounded-md lg:rounded-lg" style="aspect-ratio: 16/9; object-position: center center;" data-corners="default" data-aspect="16:9" data-caption="" data-positionx="undefined" data-positiony="undefined" data-mce-src="https://cdn.durable.co/blocks/1oNHpsZyfxrzp0jZHDl95vYefSYYGiP9WdQCP31x8Cuk5tmziUd4S6WgwZa1v7jm.jpg" data-mce-style="aspect-ratio: 16/9; object-position: center center;"></figure> <h2>More Investment in SDOH is Needed </h2>Overall, these changes can lead to reduced revenue, possibly affecting plan profitability. MA Plans will need to reconsider their strategies, including benefit offerings, premium adjustments, and engagement with underserved populations to improve or maintain Star Ratings.In light of these changes, it is critical MA plans score high on HEI to maximize bonus payments and, more importantly, could mean the difference between a 3.5 and 4 Star plan. Not only will it be important for plans to increase their social risk factor populations to meet HEI, it will also be important for plans to efficiently manage these underserved populations to ensure individual Star measures are maintained and total cost of care remains low. Populations with social risk factors are far more likely to have unmet social needs and plans will need to address these enrollees with additional social supplemental benefits and service supports to meet members social needs.Yet, providing effective social supplemental benefits and supports is hard to do. Building community level SDOH programs and engaging underserved populations at scale can be administratively challenging and operationally burdensome, which is why we built Town Square—to help reduce this burden. <h2>SDOH Made Easy with Town Square </h2>Succeed under the new CMS requirements with Town Square. Town Square’s innovative SDOH platform, local Community Guides and community level&nbsp; SDOH service network makes it easy for MA plans to capitalize on new CMS requirements and improve or maintain Star Ratings. To learn more about how Town Square can support your organization, email us at info@jointownsquare.com.

Insights - Archive

New From Town Square: Stars Medication Program

SDOH: An Untapped Profit Center

Is SDOH the Key to Unlocking MA Profitability?

MA Star Rating Changes: What You Need to Know