Transforming Member Experience: AI-Powered Reminders That Drive CAHPS Scores & Engagement

Transforming Member Experience: AI-Powered Reminders That Drive CAHPS Scores & Engagement
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A Smarter Way to Boost Member Satisfaction

For Member Experience teams at Medicare Advantage plans, improving CAHPS scores, engagement, and overall satisfaction is mission-critical. The challenge? Traditional outreach methods don’t always reach members at the right time or in the right way to drive real action.

That’s where GetSetUp’s AI-Powered Medical Adherence Reminders change the game. By embedding contextual, AI-driven nudges into live peer-to-peer programming, we help members take action when they’re already engaged in their health journey. 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.

Meet Lisa: A Member Who Needed the Right Nudge at the Right Time

Lisa, 67, from Detroit, is an active Medicare Advantage member who enjoys virtual fitness classes but often forgets to schedule her preventive care visits. One morning, as she logged into her favorite low-impact strength training session, she chatted with Helen, our AI assistant, about her recent knee pain.

Helen responded with a gentle nudge, reminding Lisa to book her annual wellness visit and check her Medicare benefits for physical therapy coverage.

Lisa, already in the mindset of investing in her health, took action immediately after class—something she might not have done if she’d simply received a generic email or phone call reminder. This is the power of engaging members at the right time.

Why This Matters for Member Experience & CAHPS Scores

Medicare Advantage plans are measured by how members feel about their care experience, including getting timely care, understanding benefits, and accessing preventive services. By integrating reminders into peer-to-peer programs, GetSetUp helps drive better experiences, higher satisfaction, and improved CAHPS scores.

  • Improves Timely Access to Care – Nudges like Lisa’s wellness visit reminder ensure members take action before issues escalate.
  • Enhances Engagement & Satisfaction – Members feel supported and informed without feeling pressured or overwhelmed.
  • Drives Proactive Health Actions – Aligning reminders with member intent leads to better outcomes and higher Star Ratings.
  • Boosts CAHPS Performance – Timely, relevant reminders improve perceptions of access to care and plan effectiveness.

How Member Experience Teams Can Use AI-Powered Reminders

  • Encourage Preventive Screenings – Nudges integrated into fitness and wellness classes increase screening participation.
  • Improve Medication Adherence – Timely, AI-powered prompts remind members to take prescriptions as directed.
  • Enhance Digital Engagement – Seamlessly introduce members to self-service tools and benefits navigation.
  • Support Chronic Disease Management – Personalized reminders help members schedule follow-ups and manage conditions effectively.

Personalized, Scalable & Data-Driven

  • 🎯 Tailored Messaging – Customize reminders to align with CAHPS priorities, such as timely care and medication adherence.
  • 🎯 Multi-Channel Delivery – Deliver reminders via SMS, email, in-app notifications, or AI chat—meeting members where they are.
  • 🎯 Real-Time Member Insights – AI learns from engagement patterns to optimize reminders for effectiveness.
  • 🎯 Impact Analytics – Track member engagement, adherence rates, and satisfaction trends to refine strategy.

The Future of Member Engagement Is AI-Driven & Contextual

Lisa’s story is just one example of how GetSetUp’s AI-Powered Medical Adherence Reminders create real impact. By reaching members when they’re most engaged, Medicare Advantage plans can drive higher satisfaction, better health outcomes, and improved CAHPS scores.

Ready to transform member experience with AI-driven engagement? Contact GetSetUp today to learn how smart reminders can drive CAHPS success and increase plan loyalty.

Bring GetSetUp to your organization

We partner with Medicare Advantage plans, dual eligible plans,  healthcare providers, Departments of Health & Human Services, Government aging services and more.