Star Ratings Managed Services
Focused on members over measures
CMS Star Ratings for Medicare Advantage and Part D plans have become increasingly more difficult for plans to maintain year over year. Black Book Research reports that the national average MA Star Rating fell from 4.07 in 2024 to 3.92 in 2025 — considered a deep decline across the industry. In 2025, only seven plans earned a 5‑star rating, down from 38 plans in 2024.
Lower Star Ratings are driven by tougher CMS methodologies, higher performance thresholds, and increased regulatory scrutiny, member experience volatility, operational burdens, and documentation rigor.
As CMS standards continue to rise, Medicare Advantage and Part D plans must modernize operational, clinical, and technology-enabled workflows to sustain performance and improve Star Ratings.
Medicare Outcomes
81% engagement rate,
64% gap resolution,
15-30% higher care gap closure;
50% appointment acceptance;
81% ROl and 3X appointment scheduling
32% fall reduction, 97%-member
resilience improvement
Zero auto forwards for a large contract,
4 years in a row
5-10% fewer repeat calls,
5% higher call efficiency
Rapid, Scalable Stars Implementation
While Star Rating improvement initiatives are embedded across our clinical and operational work, we also offer dedicated managed services for plans that need focused, end-to-end support. Built on years of experience helping plans improve Star Ratings, our approach brings together three pillars described in more detail below:
- Advanced Customer Touchpoint Analytics, Sagi360, which identify improvement opportunities
- Cross-functional Star expert team
- Technology enablers that drive scalable, sustainable performance
Combining deep analytics, our team of industry experts, and technology enablers provides a holistic strategy for improving Star Ratings.
Sagi360 Customer Touchpoint Analytics
Star Rating improvements begin by deploying our Sagi360 with deep analytics, giving health plans a holistic view of payer operations across the entire member journey.
- Process and outcome measures through measure compliance
- Experience and outcomes improving satisfaction and reducing complaints
- Cost management by reducing hospitalization and long-term care
- Reducing readmissions post an acute service
- Improving revenue by reducing churn
The second step of our Star Managed Services includes a cross-functional team of star experts with extensive expertise in contact center operations, clinical operations HEDIS measure improvement, clinical quality and compliance, business analysis, and enabling technologies.
Our experts provide insight-to-action translation, interpreting analytics, prioritizing issues, and designing quality improvement initiatives. In addition, they function as program drivers: running pilots, validating workflows and outcomes, operationalizing best practices, and creating standard operating procedures for long-term adoption. They serve as cross-ecosystem coordinators, offering governance and ensuring handoffs to internal process owners.
Technology enablers expedite processes, workflows, and operations. The enablers we deploy provide:
- Smart agent guidance: This guidance uses 360-degree customer experience (CX360) insights and analytics to deliver real-time prompts that support accurate care-gap closure.
- Gen AI-enabled workflows: These AI-powered workflows enhance agent consistency with automated documentation, guidance, and next-best-action support.
- Omnichannel engagement: Aligning engagement with a client’s digital strategy drives coordinated outreach across phone, chat, SMS, and web portals.
Decades of Partnership, Performance, and Progress.
Clients stay with Sagility for a reason: trusted expertise, measurable outcomes, and a true partnership approach. Trusted by the nation’s top health plans and providers, we bring decades of experience and a proven ability to simplify operations, improve accuracy, and deliver lasting impact.
“Excellent” NPS
Scored 52 for Customer Satisfaction
17 Years
Average Client Tenure
95%
Client Retention Rate
4 of 5
Top Health Plans Served
35k+
Global Employees
25+ Years
Claims Expertise
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