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AI Can Predict Which Members Will Struggle, But Can It Change Their Behavior?
Healthcare organizations are swimming in member data. With AI and predictive analytics, it’s much easier identify patterns in that data
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Healthcare organizations are swimming in member data. With AI and predictive analytics, it’s much easier identify patterns in that data
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Medication adherence sits at the center of chronic disease management. When members don’t take medications as prescribed, even the most effective treatment
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By midyear, Medicare Advantage plans have a much clearer picture of their Star Ratings performance. Early trends have emerged, high-risk
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As a clinical pharmacist, I’ve spent my career helping patients understand their medication and navigate increasingly complex healthcare decisions. One
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The 2027 Final Rule remains the governing rule—and outcomes still matter For years, Medicare Advantage Star Ratings performance has been
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As CMS continues shifting Star Ratings and quality programs toward outcomes-based performance, medication safety has become an increasingly important area
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Medicare Advantage plans are under increasing pressure to improve member health and outcomes— and that pressure is only accelerating. With
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Artificial intelligence is rapidly moving from experimentation to early-stage adoption across the healthcare ecosystem. For Medicare Advantage plans in particular,
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For years, health plans have leaned on live calls as the primary way to engage members about medication adherence and
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CMS is accelerating its move from process-heavy Star measures to outcomes that reflect real improvements in member health. MA plans
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For plan year 2026, Medicare Advantage has experienced significant disruption as plan offerings have shrunk and enrollment shifts have accelerated.
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Improving quality outcomes isn’t about doing more outreach—it’s about doing the right outreach, in the right order, to the right person. Across medication