AJMC August 26, 2024
Kempton Presley, MPH, MS

Strategies to help Medicare Advantage plans boost Star Ratings by improving medication adherence among seemingly “unengageable” members

Health plan specialists recognize that increased member engagement is closely linked to improved health outcomes, enhanced member experiences, and reduced medical expenses. However, individuals with high-risk health conditions, numerous social determinants of health (SDOH) challenges, and a history of non-responsiveness to both outreach and engagement efforts often pose significant challenges to health plans and are frequently considered “unengageable.”

These members are likely to struggle with basic self-management tasks, such as adhering to medication regimens—a crucial element in attaining optimal health for patients and a vital measure of care quality for the plan, directly affecting Star Ratings performance.

The importance of a focus on...

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