In the rapidly expanding Medicare Advantage (MA) landscape, health plans must develop new strategies to improve their Stars program performance or risk decreased enrollment, financial losses and compromised benefit offerings. That Stars performance improvement will be a key differentiator among plans as well as a driver of overall success.
ProspHire has assembled a team of Medicare Stars experts who will stand with you to address your current Medicare landscape, stars performance opportunities and future growth scenarios. They will develop tactics around performance measurement and improvement to rapidly help you increase your Stars rating. Contact us to get started with your Stars program evaluation.
The Medicare Advantage landscape keeps getting more competitive and Stars performance matters more than ever. Plans are facing tighter margins, shifting measures and growing regulatory uncertainty and pressure. Improving and maintaining excellence in Stars remains a critical business priority for Medicare Advantage plans.
At ProspHire, we help health plans strengthen Stars performance with a clear, practical approach. We work alongside your teams to assess where performance stands today, identify the opportunities that matter most and build a path forward that is realistic and sustainable.
Our focus does not rely on quick fixes or chasing marginal gains. It is helping plans stabilize performance, close gaps and put the right execution in place to support long term success.
How We Help
We support Medicare Advantage plans across the full Stars lifecycle, including:
- Stars Capability Assessment: Enterprise evaluation of performance, operations and governance to surface risk, quantify opportunity, and drive action.
- Operating Model & Skills Optimization: Realign roles, accountability and governance to enable disciplined execution across Stars and Quality.
- HEDIS Transformation & Digital Readiness: Diagnose capability gaps and deliver roadmaps to modernize digital quality and ECDS.
- Technology, AI & Vendor Strategy: Define high-value use cases and vendor strategies to scale performance through emerging technology.
- Stars Turnaround & Execution Support: Embed leadership and change discipline to stabilize performance and accelerate recovery.
- Analytics, Forecasting & Modeling: Deliver predictive insights and scenario modeling to secure and sustain 4+ Star outcomes.
We understand how Stars strategy shows up in real-world operations. That means fewer disconnected efforts, better alignment across teams and improvement work that sticks. Whether you are trying to stabilize ratings, protect revenue or plan for future growth, we help you move forward with confidence.
How ProspHire Can Help
See how ProspHire can help address the key issues facing your organization.
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Program Evaluation and Assessment
Begin with a proprietary Stars Capability Assessment Framework, layering in a data-driven analysis and insights to yield a deeper understanding of your organization and Stars specific challenges.
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HEDIS Medical Record Review
Identify gaps and opportunities and implement best-practice strategies and process improvement techniques that enable improved HEDIS measure performance and increase chart retrieval rates.
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Program Transformation Execution
Combine strong governance, measure-level accountability, data-driven intervention design and execution efforts to improve Stars ratings.
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Strategic Visioning and Planning
Develop long-term sustainable strategies for Stars improvement from intervention ideation to resource planning and development to budget management all aimed at achieving 4.0 Star success.
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Member Experience Optimization
Leverage behavioral science capabilities with program management expertise to cultivate and foster meaningful and impactful member experiences that enable Stars success.
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Advisory Services
With an ever-changing and dynamic regulatory landscape, success in Medicare Stars demands a strong attention and expertise to navigate measure-level changes, scoring methodology impacts and program level effects.
