Five Stars Traps to Avoid in 2025: Insights from our Chief Medical Officer

Dr. Bonnette, Chief Medical Officer, kicked off a video series with Slice of Healthcare to help health plan leaders rethink their approach to CMS Star Ratings. In Part 1 of this recap, we break down his top takeaways from the first two conversations.

CMS recently released its 2025 fact sheet on Star Ratings, showing a continued decline in average Medicare Advantage plan performance – down 0.12 points form 2024. So, what’s going wrong?

In my first two conversations with Slice of Healthcare, the discussion covered the dangers of fragmented strategies and why a member-first approach is necessary. Here are the takeaways:

Conversation #1: Build A Stars Strategy That Shines

The problem with many traditional health plan outreach methods is the use of siloed strategies and too many vendors. Many health plans spread performance measures across dozens, sometimes hundreds, of vendors. This results in no coordination, conflicting outreach, and a complete lack of addressing members’ actual needs. One plan I have spoken to in the past had 300 vendors – making coordination across all quality measure programs virtually impossible.

Avoid:

• Fragmented outreach, each vendor focused on only one measure.
• Disconnected messages bombarding members.
• Overinvestment in low-impact measures, like basic screenings, that contribute little to Star performance but a lot to member abrasion.

Instead of focusing on each quality measure, health plan leaders should take a centralized approach that puts the member first. Here are three suggestions to consider:

• Put the member first: Start by addressing their needs, not just performance measures.
• Offer more information and assistance during each interaction: If members get help on only one issue per call, they will start to tune out any following outreach attempts.
• Target high-weighted measures: CMS prioritizes outcomes like medication adherence for hypertension and HbA1C control, weighing them much higher than screening attempts.

Conversation #2: When Healthcare Outreach Feels Like Spam

Members quickly disengage when they feel overloaded with outreach. In my personal experience signing up for Medicare, I received 45 pieces of mail in one month – most of which went straight into the trash. Overwhelming and impersonal outreach tarnishes the trust members should have with their plan.

Avoid:

• Reliance on numerous vendors making separate calls, sending duplicate mail, or repeating questions.
• One-size-fits-all messages without understanding and addressing the full context of each member’s health.

Rather than relying on each vendor’s individual outreach methods and channels, tailor engagement with each member in mind. Here are tips for member-specific outreach: 

• Rethink vendor management: Fewer and better-equipped, holistic vendors can address multiple issues in one engagement.
• Train for empathy: Encourage vendors and staff to treat members like family – what would you want your grandmother or grandfather to experience?
• Lead with offering help: Effective outreach starts with solving the real problems each member faces. Begin by asking “how can I help?”

Health plans need more effective strategies. A unified, member-first approach improves engagement, reduces abrasion, builds trust, and actually drives better Star Ratings.