Star Ratings Managed Services
Focused on members over measures.
CMS Star Ratings for Medicare Advantage and Part D plans have become increasingly more difficult for plans to maintain year over year. Black Book Research reports that the national average MA Star Rating fell from 4.07 in 2024 to 3.92 in 2025 — considered a deep decline across the industry. In 2025, only seven plans earned a 5‑star rating, down from 38 plans in 2024.
Lower Star Ratings are driven by tougher CMS methodologies, higher performance thresholds, and increased regulatory scrutiny, member experience volatility, operational burdens, and documentation rigor.
Rapid, Scalable Stars Implementation
As CMS standards continue to rise, Medicare Advantage and Part D plans must modernize operational, clinical, and technology-led workflows to sustain performance and improve Star Ratings. We increase performance across our clinical and operational work. We also offer dedicated managed services for plans that need focused, end-to-end support. Built on years of experience helping plans improve Star Ratings, our approach brings together three pillars described in more detail:
- Advanced Customer Touchpoint Analytics, Sagi360, which identify improvement opportunities
- Cross-functional Star expert team
- Technology enablers that drive scalable, sustainable performance
Medicare Outcomes
Medicare Payer Partners
Medication Adherence
81% engagement rate
64% gap resolution
HEDIS Gaps Closed
15-30% higher care gap closure
50% appointment acceptance
81% ROl and 3X appointment scheduling
Enrolled Members
Aging in Place
32% fall reduction,
97%-member resilience improvement
Appeals Auto Forward Reduction
Zero auto forwards for a large contract 4 years in a row
Medicare Contracts Serviced
CAHPS Optimization
5-10% fewer repeat calls
5% higher call efficiency
Three-Pronged Approach to Improve Stars
Combining deep analytics, our team of industry experts, and technology enablers provides a holistic strategy for improving Star Ratings.
Sagi360 Analytics
Star Rating improvements begin by deploying Sagi360 Customer Touchpoint Analytics. This offering, with deep analytics, gives health plans a holistic view of payer operations across the entire member journey.
- Process and outcome measures through measure compliance
- Experience and outcomes improving satisfaction and reducing complaints
- Cost management by reducing hospitalization and long-term care
- Reducing readmissions post an acute service
- Improving revenue by reducing churn
Star Teams
Star360 Super User Teams make up the second step of our Star Managed Services. A cross-functional team of star experts with extensive expertise in contact center operations, clinical operations HEDIS measure improvement, clinical quality and compliance, business analysis, and enabling technologies.
Our experts provide insight-to-action translation, interpreting analytics, prioritizing issues, and designing quality improvement initiatives. In addition, they function as program drivers: running pilots, validating workflows and outcomes, operationalizing best practices, and creating standard operating procedures for long-term adoption. They serve as cross-ecosystem coordinators, offering governance and ensuring handoffs to internal process owners.
Technology Enablers
Technology enablers expedite processes, workflows, and operations. The enablers we deploy provide:
- Omnichannel engagement: Aligning engagement with a client’s digital strategy drives coordinated outreach across phone, chat, SMS, and web portals.
- Smart agent guidance: This guidance uses 360-degree customer experience (CX360) insights and analytics to deliver real-time prompts that support accurate care-gap closure.
- Gen AI-enabled workflows: These AI-powered workflows enhance agent consistency with automated documentation, guidance, and next-best-action support.
Our Accreditations
Industry-recognized certifications that demonstrate our commitment to quality, security, and excellence.
Straight from the Source
We’re more than a vendor, we’re a partner. Here’s what our clients have to say:
The team has been exceptional. They are responsive, have great communication skills, and have helped us streamline our claims processing workflow. Their AI-powered solutions have significantly reduced our manual workload and improved accuracy rates across the board.
VP of Operations,
U.S. Fortune 100 health insurance company
Their innovative approach to revenue cycle management transformed our operations. We saw a 40% reduction in claim denials and a 30% improvement in processing speed within just three months of implementation.
Chief Financial Officer,
Regional hospital network
The implementation was seamless, and their support team is outstanding. We’ve achieved 98% accuracy in claims processing and reduced our days in A/R from 45 to 28. Their technology is truly game-changing for healthcare providers.
Revenue Cycle Director,
Multi-specialty physician group
Case Studies
See how we’ve helped payers unlock millions in savings and streamline operations:
Insights & Resources
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