DALLAS, October 29, 2025 /BusinessWire/ — Healthmine, a leading member engagement solution for health plans, announced that its clients achieved significant performance gains in the 2026 CMS Star Ratings, underscoring the impact of effective member engagement and a proactive, data-driven strategy.
More than 25% of Healthmine’s clients improved their overall Star Rating, with over 30% now achieving 4 stars or higher. These results reflect the measurable impact of Healthmine’s engagement platform and quality improvement programs in helping health plans connect with members and drive meaningful health outcomes.
In addition to overall rating improvements, Healthmine clients also outperformed on key measure-level improvements, including:
- Special Needs Plan (SNP) Care Management: +6% improvement
- Colorectal Cancer Screening (COL): +18% improvement
- Members Choosing to Leave Their Plan: +21% improvement
- Member Rating of Health Plan: +20% improvement
To help plans navigate these changes, Healthmine will host a webinar on November 18 to dive deeper into the 2026 Star Ratings results, explore the upcoming changes and demonstrate how plans can enable real-time data to drive member action that accelerates plan performance.
“These results clearly show the power of engagement-driven quality improvement,” said Dwight Erskine, CEO at Healthmine. “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.”
Next year, health plans will be faced with several challenges, including the new Excellent Health Outcomes for All (EHO4All) reward to replace the Reward Factor, the continued transition to Electronic Clinical Data Systems (ECDS) reporting and new Part D measures. Additional changes are yet to be announced by the Centers for Medicare & Medicaid Services (CMS).
“All plans will be affected by these upcoming changes,” said Erskine. “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.”
About Healthmine
Healthmine is the industry’s leading member engagement solution, simplifying how health plans make the most of every member moment. Our SaaS-based, always-on Quality Relationship Management™ (QRM®) platform eliminates data chasing so plans can capture whole views of each member. Our team of behavioral scientists and regulatory experts partner with each health plan to use this member-level detail to build personalized outreach that motivates members to take the right next step in their health journeys. With customized triggers based on clinical, pharmacy, CAHPS and HOS measures, and when paired with intelligent incentives, plans can see accelerated results in health equity and member outcomes while better managing medical spend and reducing the burden on their teams. Real-time data dashboards with actionable insights allow plans to act fast and better prioritize areas of opportunity to meet revenue and quality goals. Connect with us at Healthmine.com and on LinkedIn.
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