Dec 19, 2024
Blog
Cue the fireworks! The talented teams at MetaStar are celebrating 2024: a year marked by excellence, teamwork, and unwavering dedication to improving healthcare quality. This year has been a testament to their mission to effect positive change in health and healthcare and to provide quality health for all. Below, some of the projects and collaborations from 2024 are showcased. These projects demonstrate the myriad ways MetaStar uses its unique position as Wisconsin’s largest independent healthcare quality organization to drive health care quality, safety, and equity outcomes. Looking ahead, they see even greater possibilities in the years to come.
Data-Driven Opportunities
Jesi Wang, MetaStar President and CEO
“The support MetaStar provides organizations and communities is a little bit like glue,” said Jesi Wang, President and Chief Executive Officer (CEO) of MetaStar. “When the glue is working well, you hardly notice it, but it holds everything together. When it’s not there, things have a hard time sticking.” This “glue” comes in the form of the various reviews, consulting, support, auditing, and more that MetaStar does to ensure quality healthcare for the residents of all 50 states.
One essential part of that work is external quality reviews. MetaStar has over 45 years of experience performing independent assessments, helping organizations meet and exceed the standards set by The Centers for Medicare & Medicaid Services (CMS). “We see it as an opportunity to shine a light on organizational and programmatic areas for growth and improvement,” Wang said. “That allows government agencies and healthcare organizations to focus on meaningful changes that strengthen quality and equity in care.”
External quality reviews play a key role in helping organizations and providers understand evolving standards and guidelines set by government or professional associations. In the video below, Vanessa Lamal and Lauren Mueller, two of MetaStar’s nurse reviewers, share their experience supporting organizations as they implement new guidelines from the American College of Obstetricians and Gynecologists, helping ensure providers are equipped to deliver high-quality care to mothers during the post-partum period.
Another example of how independent review and oversight drive quality is the significant improvement in care plans across seven Medicaid and Home and Community-Based Services (HCBS) programs—including Children’s Long-Term Support Program (CLTS), Family Care, Family Care-Partnership, Program for All-Inclusive Care for the Elderly (PACE), and Include, Respect, I Self-Direct (IRIS). The percentage of care plans documenting the strengths, preferences, and needs of members increased from 73.5% last year to 94.2% this year.
MetaStar also plays a critical role in supporting timely grievance and appeal investigations. As of November 11, 2024, 651 investigations were completed for the IRIS program, which empowers adults with disabilities and older adults in Wisconsin to make decisions about how they want to live their lives. MetaStar serves as a trusted third-party mediator, addressing issues between Medicaid recipients and service or support providers.
Collaborating for Improved Care
MetaStar focuses on improving healthcare quality in underserved and underrecognized areas. One of those areas is another topic in women’s health—urinary incontinence (UI), an uncomfortable topic for many. “We also work to effect change where there might be stigma or things folks don’t want to talk about,” Wang explained. “Urinary incontinence in women isn’t a provocative, sexy topic, but it has great impact on the lives of the individuals who suffer from it.”
In collaboration with University of Wisconsin-Madison’s School of Medicine and Public Health, the Medical College of Wisconsin, and the Agency for Healthcare Research & Quality, MetaStar successfully integrated screening guidelines for UI into medical practice. This enabled competent and caring discussion of the topic, breaking down the stigma surrounding it. One of MetaStar’s practice facilitators, Hannah Trickel, explains the way MetaStar relied on established relationships and collaboration with other organizations to advance quality for women in Wisconsin.
One of the strategic advantages of MetaStar is that “we really believe in collaborative solutions and collaborative impact,” said Wang. This collaborative partnership resulted in a significant improvement in women’s UI screening: it improved by an average of 47%, exceeding the original 20% goal.
Another example of MetaStar’s collaborative efforts to improve care and reduce stigma is its focus on advancing behavioral health, particularly addressing substance- and opioid-use disorders. As a partner organization of Superior Health Quality Alliance, MetaStar has played a key role in producing trainings, videos, and resources tailored for multiple care settings. One impactful initiative is the “Shine A Light On Stigma” campaign, which encourages organizations to pledge to eliminate stigmatizing language related to behavioral health and substance use. “By working together, we can create a more compassionate and supportive environment for all individuals,” Wang explained.
Ensuring Data Reliability
MetaStar’s certified auditors validate and certify data for programs such as HEDIS®, URAC, and more, ensuring accuracy and reliability in reporting. The MetaStar team ensures organizations meet rigorous standards and regulatory requirements, helping organizations maintain compliance, enhance data integrity, and drive quality improvement initiatives.
“We view ourselves as not just a vendor who’s going to check the boxes for [customers], but as someone who can help them solve problems,” said Wang. “It shows up in the way we do our work and the way that our staff partner with individuals and organizations.” Ross Gatzke, URAC and Initial Validation Audit (IVA) project lead at MetaStar, shares a challenging situation where they were asked to perform a URAC data audit in six weeks instead of the usual three or four months. Gatzke explains how MetaStar made it happen.
In 2024, MetaStar completed 311 performance measurement audits and supported 159 customers. This superior customer service leads to MetaStar’s high quality outcomes and customer satisfaction results Wang cites this ethos as one of the things she’s most proud of at MetaStar: “Everyone [at MetaStar] makes a commitment to show up, and they really believe in the work that we do. They believe in the impact we can have and take that extra step.”
Using the Past to Improve the Future
“The impact and progress in 2024 mark another year of success and valuable experience building quality infrastructure for organizations across the state and the country,” said Wang. While 2024 is projected to be MetaStar’s most successful year in the last decade, Wang is already looking ahead. MetaStar has already identified three critical impact priorities for 2025: continuing to advance behavioral health, expanding quality in home and community care, and strengthening equity and quality. One area of focus will be on unhealthy alcohol use. “Wisconsin continues to be a ‘leader’ of unhealthy alcohol use and behaviors,” Wang explained. Bringing together a wide range of collaborators, Wang is excited to “think about how holistically we could drive change across the state.”
As priorities evolve, Wang is confident MetaStar will remain a leader in healthcare quality improvement. With over 50 years of experience in this space, she believes MetaStar will continue to innovate and advocate for optimal health for all. “We have a deep history of doing this work, and that commitment isn’t going to change,” said Wang. “The organizations we partner with are doing tremendous work, and while there are many challenges, it is those challenges that drive us. We’re motivated by the opportunities for change, working every day to make healthcare better.”