Episode 6: The 3 Card Monty of CMS Stars: Mastering Variable Change
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Episode 6: The 3 Card Monty of CMS Stars: Mastering Variable Change
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In this episode, we use the mathematics of a fair game of Three Card Monte, and the principle of variable change, to explain why most health plans lose money on their quality Improvement investments. Bert walks through conditional probability, Bayesian updating, and how to apply both at the macro measure level and at the individual patient intervention level. The episode closes with the Health Equity Index as the nextmajor variable change in Medicare Advantage and three operational principles for building an organization that can execute a pivot before it's too late.
Topics Covered:
1. Variable change and conditional probability
2. How CMS cut points move
3. Real-world mid-year pivot strategy
4. Bayesian updating in patient-level care management
5. Stars measure weighting shifts and organizational response
6. Health Equity Index, what it means for 2027 Star Ratings
7. Building a culture of dynamic quality strategy