Situation

Improving Part D Star Ratings is critical for Medicare Advantage plans, but the process is labor-intensive and inefficient. Whether it’s ensuring medication adherence for diabetes, hypertension, or cholesterol, or driving completion rates for Medication Therapy Management (MTM) programs, the work typically relies on repetitive, manual member outreach. Care teams send reminder emails, make phone calls, or even mail letters, only to see low engagement and minimal improvement in metrics. The result? Random acts of engagement that produce marginal gains, while the care team is stretched thin.

Complication

The over-reliance on human-driven workflows creates inefficiencies and limits scalability. Members often fail to engage with outreach that feels impersonal, untimely, or irrelevant. Medication adherence suffers, complaints increase, and MTM completion rates stagnate. Without a systematic approach to testing and refining outreach strategies, organizations struggle to improve outcomes and deliver on high-value measures like drug plan quality improvement or intermediate outcome metrics. Add in state-specific regulatory and member nuances, and the complexity grows exponentially.

Resolution

Care teams use Awell to improve Part D metrics with a powerful, automated engagement solution. Value-based care organizations automate outreach across multiple channels—text, email, voice AI, or physical mailers—while experimenting with messaging strategies to see what works best. Teams use Awell’s experimentation engine to test approaches like medication adherence reminders or MTM program enrollment and track which strategies resonate most with members.

For example, the system sends personalized medication reminders based on refill schedules and preferred communication channels. High-risk members who don’t respond are escalated to care coordinators for follow-up. If a member reports barriers, such as cost concerns for a prescription, workflows are triggered automatically to connect them with assistance programs. The platform even accommodates state-specific messaging to address regulatory and member nuances seamlessly.

By automating repetitive tasks and using data insights to optimize engagement, care teams drive measurable improvements in medication adherence, MTM completion rates, and member satisfaction. This approach allows teams to focus their time on complex, high-value interactions while organizations achieve scalable, data-driven engagement that boosts Star Ratings and improves outcomes.