MEDICARE ADVANTAGE · PART C & D STAR RATINGS
516 contracts compete.
207 earn the bonus.
What separates them is a few hundred members whose prescriptions ran out early — and who can still be reached. AdherenceStar finds them while the year can still be saved.
Built for plans that carry the Stars number without a data-science team behind it.
36% of MA-PD enrollment sits in contracts rated below 4 stars, outside the quality bonus. The single most common rating is 3.5 — 175 contracts, one step below the line.
ONE MEMBER, ONE YEAR
Adherence is a ceiling that falls.
Every uncovered day permanently lowers the best result a member can still reach. Miss enough of them and eighty percent becomes unreachable — months before anyone would notice on a year-end report.
JANAPRJULOCTDEC
Covered daysGap days — each one lowers the ceilingRemaining year
PDC to date72%114 of 158 days covered
Still achievable88%if every remaining day is covered
Recoverable untilJul 6after this date, 80% is unreachable
The same outreach is worth far more in March than in October. Illustrative member; synthetic data.
WHY THIS IS DIFFERENT
Most tools tell you who failed. We tell you who you can still save.
01Your rates are computed hereProportion of days covered, calculated member by member from your own claims, following that measurement year’s specification — then reconciled line by line against your official CMS report before anyone acts on it.
02Recoverability, not another gap listAny report can name your non-adherent members. We compute the date each one becomes mathematically unreachable, and rank by what the recovery is worth in star movement.
03Rule changes arrive as contentCMS drops eleven measures by the 2029 Star Ratings and recalculates cut points every year. Each measurement year ships as a versioned rulepack — an update you receive, not a release you wait for.
04Your team keeps the workNo delegated clinical staff, no multi-month integration. Upload two files and see where you stand the same day. The plan keeps the members, the outreach, and the relationship.
WHO THIS IS FOR
Plans close enough to a cut point that a few hundred members decide it.
Plan size10,000 – 250,000 members. Regional plans, not national carriers.
ContractsMedicare Advantage Prescription Drug, and standalone Part D. Part D adherence first; Part C quality measures from your medical claims and clinical feeds.
The momentSitting at 3.5 stars — or defending a 4.0 you cannot afford to lose.
Your teamQuality, pharmacy, care management. No data engineers required.
Six Part D measures come from your own pharmacy claims
Each adherence measure counts triple — three times a process measure — and the three together carry about a third of the Part D rating.
3×Medication Adherence for Diabetes Medications
3×Medication Adherence for Hypertension (RAS antagonists)
3×Medication Adherence for Cholesterol (Statins)
1×Statin Use in Persons with Diabetes
1×Concurrent Use of Opioids and Benzodiazepines · rated from 2027
1×Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults · rated from 2027
See it against your own contract.
Upload two files and see where you stand the same day. In active development, onboarding early plans now.