Healthmine, a provider of member engagement solutions for health plans, announced that its clients demonstrated significant improvements in the 2026 CMS Star Ratings, with over 30% achieving 4 stars or higher.
This achievement highlights the impact of Healthmine’s data-driven member engagement strategy and quality improvement programs. More than 25% of Healthmine’s client base improved their overall Star Rating, surpassing national averages.
Beyond overall rating enhancements, Healthmine clients also reported notable gains in key measure-level categories. These included a 6% improvement in Special Needs Plan (SNP) Care Management, an 18% improvement in Colorectal Cancer Screening (COL), a 21% improvement in reducing members choosing to leave their plan, and a 20% improvement in member rating of their health plan.
Dwight Erskine, CEO at Healthmine, commented on the results, stating, “These results clearly show the power of engagement-driven quality improvement. We work side by side with our clients to identify the highest-impact opportunities and design programs that don’t just reach members but truly move them to action. Driving improvement in the areas most impactful to their members and their financial performance.”
Looking ahead, health plans are preparing for several changes in the upcoming year, including the introduction of the new Excellent Health Outcomes for All (EHO4All) reward, which will replace the current Reward Factor. The transition to Electronic Clinical Data Systems (ECDS) reporting and the implementation of new Part D measures are also underway, with additional changes from the Centers for Medicare & Medicaid Services (CMS) expected.
Erskine added, “All plans will be affected by these upcoming changes. Medicare Advantage plans previously receiving a financial lift with the Reward Factor will find it more difficult to earn rewards under the EHO4All. For plans not engaged with Healthmine, performance for new ECDS measures has dropped significantly in year one for each measure. It is time for payers to operate differently.”
To assist plans in navigating these changes, Healthmine will host a webinar on November 18. This event will delve into the 2026 Star Ratings outcomes, discuss anticipated changes, and demonstrate how real-time data can be leveraged to drive member action and accelerate plan performance. Healthmine’s Quality Relationship Management™ (QRM®) platform aims to provide a comprehensive view of each member, enabling personalized outreach and intelligent incentives to improve health outcomes and manage medical spend.
