AI-Powered Adherence: The Key to Higher Star Ratings & Better Health Outcomes
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For managers of Quality at Medicare Advantage plans, the mission is clear: improve Star Ratings, drive better health outcomes, and increase member engagement. The challenge? Medication non-adherence, missed preventive screenings, and low engagement are holding back performance metrics and increasing healthcare costs.
That’s where GetSetUp’s AI-Powered Medical Adherence Reminders come in. Designed to integrate seamlessly into live peer-to-peer programming, these intelligent nudges help Medicare members take the right action at the right time—improving medication adherence, preventive care participation, and overall engagement. GetSetUp has spent over five years teaching older adults the most important skills needed to live active, independent lives. With over 10 million classes delivered, we have gathered deep insights into how older adults learn, engage, and seek information. This expertise has shaped our AI’s ability to provide empathetic, accessible, and member-focused guidance—something traditional AI tools often lack. Unlike generic digital assistants, GetSetUp’s AI has been trained to understand the unique needs of older adults, including their vocabulary, learning styles, and concerns about healthcare navigation.
The Difference: Reminders That Meet Members Where They Are
Traditional reminders rely on generic notifications that members ignore. GetSetUp takes a different approach by embedding reminders into live classes, fitness programs, and community discussions where members are already engaged in their well-being.
- 💡 In a fall prevention class? That’s the moment to remind a member to schedule a balance assessment or check their Medicare coverage for physical therapy.
- 💡 Attending a fitness session? Helen, our AI assistant, surfaces nudges for preventive screenings, wellness checkups, and chronic disease management programs.
- 💡 In a nutrition workshop? A timely reminder to book an annual wellness visit or check eligibility for SNAP benefits and senior nutrition programs.
- 💡 Learning digital skills? A great opportunity to encourage members to set up MyMedicare.gov, review coverage, or update direct deposit settings.
By delivering AI-driven reminders in the moments that matter, we ensure that members act on their health rather than dismiss another impersonal alert.
How AI-Powered Reminders Drive Action: Meet George
George, an 80-year-old Medicare Advantage member, loves attending technology classes at GetSetUp. He enjoys learning new skills and staying connected with the latest digital tools. During one of his favorite classes on smartphone basics, he started chatting with Helen, our AI assistant.
Helen recognized that George was actively engaging with technology and surfaced a timely reminder: “Did you know your Medicare Advantage plan has a mobile app? Download it now to access your benefits and schedule appointments easily.”
Intrigued, George clicked the link and, with the instructor’s guidance, downloaded his health plan’s app right there in class. Within minutes, he was able to check his upcoming wellness visit, review his prescription refills, and explore additional plan benefits.
This real-time engagement made the difference—instead of ignoring another generic notification, George took action in a moment where he was already focused on learning and improving his digital skills.
Why This Matters for Star Ratings & Health Outcomes
With Star Ratings and member experience measures carrying more weight in CMS evaluations, high-impact engagement strategies are essential. GetSetUp’s AI-powered reminders help increase participation in key quality metrics that drive Star Ratings:
- ✅ Boosts Medication Adherence (CMS Triple Weight Measure) – Reduces hospitalizations and ER visits by ensuring members take medications on time and as prescribed.
- ✅ Increases Preventive Care Participation – Drives completion of cancer screenings, flu vaccinations, and annual wellness visits.
- ✅ Improves Chronic Condition Management – Encourages adherence to treatment plans, blood pressure monitoring, and diabetes screenings.
- ✅ Enhances CAHPS & Member Engagement Scores – Builds trust by integrating reminders within a social learning environment, where members feel supported and empowered.
How Medicare Advantage Plans Can Leverage This AI Solution
- 📌 Increase Medication Adherence – AI-powered reminders prompt members to refill and take prescriptions at the right time, reducing readmissions.
- 📌 Drive Preventive Screenings – Contextual nudges direct members to flu shots, mammograms, colonoscopies, and annual physicals.
- 📌 Support Chronic Disease Management – AI helps members track appointments, self-care routines, and engagement in wellness programs.
- 📌 Strengthen Member Engagement – Personalized reminders encourage participation in fitness classes, mental health support, and digital health literacy programs.
Customizable for Maximum Impact
- 🎯 Tailored Messaging – Align reminders with Star Ratings goals, preventive care initiatives, and member experience strategies.
- 🎯 Multi-Channel Delivery – Reach members via SMS, email, in-app notifications, or AI chat.
- 🎯 Personalized Member Experience – AI adapts messages based on member behavior, conditions, and past engagement.
- 🎯 Performance Tracking – Analytics measure impact on Star Ratings, adherence rates, and engagement trends.
A Data-Driven Strategy for Improving Star Ratings
AI-powered reminders are more than just notifications—they are a proactive, embedded engagement tool that aligns with CMS’s push for improved health outcomes and patient-centered care.
With GetSetUp’s AI-Powered Medical Adherence Reminders, Medicare Advantage plans now have a scalable, intelligent solution to increase adherence, boost preventive care participation, and improve Star Ratings—while enhancing the member experience.
The future of Medicare member engagement is here. Are you ready to take your plan’s quality performance to the next level? Contact GetSetUp today to see how AI-powered reminders can help you improve Star Ratings, reduce costs, and drive better health outcomes.
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We partner with Medicare Advantage plans, dual eligible plans, healthcare providers, Departments of Health & Human Services, Government aging services and more.
