Don’t Just Improve Experience. Shoot for the STARS.

In Medicare Advantage, experience matters.
But STARS revenue drives survival.

Plans don’t lose contracts because of branding. They lose revenue because adherence gaps widen, follow-ups are missed, medication lists go unchecked, and preventable admissions increase. STARS is not abstract — it is operational. It is clinical. It is measurable.

And it is fixable.

HealthAgent is not building a general AI assistant. We are building deterministic workflows engineered specifically around STARS revenue drivers.

Step One: Adherence as a Closed-Loop System

We start where STARS is most exposed: Part D medication adherence.

Not reminders.
Not nudges.
Not generic engagement.

Closed-loop adherence workflows that:

• Detect refill risk early

• Surface exact prescription data

• Initiate refill requests

• Confirm medication “in hand”

• Escalate when barriers appear

• Track resolution as a measurable outcome

STARS doesn’t reward notifications sent.
It rewards adherence achieved.

Our system is designed around that distinction.

From Adherence to Preventive Follow-Up

Adherence is the entry point — not the destination.

The same deterministic logic extends into:

• Preventive care reminders tied to specific HEDIS measures

• Annual wellness visits

• Chronic disease lab monitoring

• Cancer screenings

• Care gap closure workflows

Each workflow is structured with a beginning, action trigger, escalation path, and resolution state.

Because STARS revenue is not about awareness.
It’s about completed actions.

Post-Discharge: Where Revenue Leaks

One of the most expensive breakdowns in Medicare Advantage is post-discharge management.

Missed follow-ups.
Medication discrepancies.
Unclear instructions.
Preventable readmissions.

HealthAgent inserts a structured agent layer immediately after discharge:

• Medication reconciliation workflows

• Identification of missing or duplicate prescriptions

• Follow-up appointment scheduling support

• Escalation to care teams when risk flags appear

• Confirmation of task completion

This is not passive monitoring.

It is deterministic post-discharge orchestration.

Medication Reconciliation & MTM: Precision Over Prompts

Medication reconciliation and MTM are often treated as periodic compliance exercises.

We treat them as active risk engines.

HealthAgent can:

• Compare discharge lists to active pharmacy records

• Flag gaps or duplications

• Initiate clarification workflows

• Track resolution confirmation

• Support MTM interventions with structured escalation logic

This moves medication reconciliation from documentation to execution.

Engineering for STARS Revenue

HealthAgent is architected around measurable revenue drivers:

• Part D adherence (PDC improvement)

• Preventive screening completion

• Post-discharge follow-up rates

• Medication reconciliation accuracy

• Care gap closure velocity

Every workflow has:

• Trigger logic

• Risk stratification

• Escalation criteria

• Deterministic action steps

• Confirmed resolution states

Because STARS performance is not influenced by sentiment alone.
It is influenced by actions completed at scale.

A System of Action for Medicare Advantage

Many solutions try to influence behavior.

We are building a system that influences outcomes.

Adherence → Preventive Care → Post-Discharge → Medication Reconciliation → MTM.

Each layer compounds revenue protection.

Each workflow reduces friction.

Each resolution state protects STARS performance.

HealthAgent is not experimenting with AI for novelty.

We are engineering agentic workflows specifically designed to protect and grow Medicare Advantage revenue.

Don’t just hope for better STARS.

Build for them.