Medicare Advantage plans are struggling to maintain high Star Ratings amid shifting CMS requirements, rising enrollment and increasing focus on health equity. These challenges threaten both compliance and revenue, especially with the loss of quality bonus payments for underperforming plans. To remain competitive, health plans must adopt proactive, data-driven strategies that address evolving metrics and regulatory volatility while improving member outcomes.

HCLTech’s Star Rating Assist offers a GenAI-powered solution that helps health plans proactively manage and improve their ratings. It integrates diverse data sources, predicts cut points with high accuracy and delivers real-time insights and recommendations to drive sustainable performance improvements. The solution also supports role-specific workflows, enabling quality managers, clinicians and executives to collaborate effectively and act on timely, actionable intelligence.