Definition
Medicare Star Ratings are the one-to-five-star quality scores that CMS publishes each year for Medicare Advantage and Part D prescription drug plans.
Ratings combine measures drawn from HEDIS, member experience surveys (CAHPS), the Health Outcomes Survey, and Part D and administrative data. They matter financially: Medicare Advantage plans rated four stars or higher qualify for quality bonus payments, and ratings influence enrollment because beneficiaries see them when choosing a plan.
Post-discharge contact, medication adherence, and preventive care all feed measures behind Star Ratings, as does member experience. That links outreach operations directly to plan revenue: a cohort that is not reached is both a clinical gap and a ratings risk.
How Consig handles it
Consig's health-plan use cases include post-discharge follow-up and medication-adherence outreach, positioned to improve HEDIS and Star Ratings by closing care gaps at higher volume without added headcount.