Medicare Advantage Member Engagement That Boosts Star Ratings
Compliance-first Medicare Voice AI that closes care gaps, improves HEDIS and CAHPS scores, and increases member retention through intelligent, scalable outreach, driving better outcomes and higher CMS Star Ratings. coverage voice automates welcome calls, risk assessments, and satisfaction follow-ups to help payers and MA plans improve member satisfaction while maintaining full compliance.
The Stars Rating Crisis Facing MA Plans
Medicare Advantage plans face mounting pressure to improve Star Ratings while managing member engagement at scale. Missed welcome calls, incomplete HRAs, and care gaps directly impact quality scores and revenue.
Star Rating Impact
Onboarding Dissatisfaction
High Member Churn
Survey Period Gaps
Missed Welcome Calls
Lost Revenue
Medicare Voice AI Solution: Intelligent Member Outreach at Scale
Automated Welcome Calls & HRA Completion
- 30-Day Compliance Calls – AI connects with every new member within CMS's required timeframe.
- Empathetic Conversations – Personalized, natural calls that build trust and improve satisfaction.
- Health Risk Assessments – Collects HRA data, verifies PCP selection, and explains benefits.
- High-Risk Alerts – Flags members for case management and pre-schedules follow-ups with context.
- Survey Score Boost – Enhances CAHPS responsiveness and HEDIS "Follow-up After Hospitalization" scores.
Care Gap Closure & HEDIS Improvement
- Preventive Screenings – Reaches members who missed mammograms, colonoscopies, and diabetes exams.
- Medication Adherence – Detects unfilled prescriptions and coordinates pharmacy follow-ups.
- Automated Scheduling – Books preventive and chronic care appointments without staff overhead.
- Data-Driven Logging – Records every encounter with codes and timestamps into analytics dashboards.
- Proven Impact – 35% higher care gap closure and 90% HRA completion within 30 days.
CAHPS & HOS Survey Optimization
Consumer experience defines Star Ratings. coverage voice drives measurable improvement by conducting ongoing check-ins covering the same domains CAHPS evaluates:
- Getting needed care quickly
- Care coordination and communication
- Monitoring physical activity and chronic conditions
- Addressing fall risk and bladder control
Compliance-First Architecture for Regulated Environments
HIPAA & Security Standards
- SOC 2 Type II certified
- End-to-end encryption
- HIPAA BAA included
- 10-year secure storage
CMS Compliance Features
- 30-day welcome call compliance
- HRA completion tracking
- Care gap documentation
- Audit-ready reporting
Measured Impact on Health Plan Performance
Star Rating Improvements
- • 0.5–1.0 average Star Rating gain within one measurement cycle
- • 90% HRA completion vs. 60–70% industry average
- • 35% higher care gap closure rates
Member Retention
- • 37% average retention improvement with year-round AI engagement
- • Automated renewal reminders and satisfaction surveys reduce churn
Operational Efficiency
- • 50% reduction in outreach costs
- • Unlimited scalability during AEP and survey periods
- • Elimination of temporary staffing costs
Why Payers & MA Plans Choose coverage voice
Close More Care Gaps
Boost Star Ratings
Improve Member Experience
Strengthen Compliance
Scale Effortlessly
Proven Results
Proven Results
| Metric | Before AI | After coverage voice |
|---|---|---|
| HRA Completion Rate | 65% | 90% |
| Care Gap Closure | 45% | 80% |
| Retention Rate | 63% | 87% |
| Outreach Cost per Member | $12 | $6 |
| Star Rating Improvement | 3.5 | 4.2 |
Trusted by Medicare Advantage Plans Nationwide
Lisa Gomez
Operations Manager, National Broker Network
"From data chaos to complete visibility. coverage voice's AI-powered Medicare compliance dashboard shows call volumes, SOA status, and warm-transfer metrics in one place. It's like adding an extra manager that never sleeps."
Michael Jones
Quality Director
"We finally reached every member during the HEDIS cycle. AI voice agents handled thousands of care gap calls compliantly."
Automate Member Engagement Before the Next Measurement Period
Don't let missed calls lower your Star Ratings. See how coverage voice's Voice AI for Medicare Advantage improves quality scores, retention, and compliance in weeks not months.