Improving CMS Star Ratings Through Targeted Member Engagement

How Combining Flex Cards and Rewards Builds Trust, Motivates Healthy Behaviors, and Improves Outcomes

Maintaining and improving CMS Star Ratings has never been more challenging or more consequential for Medicare Advantage plans. As margins tighten, member expectations rise, CMS continues to refine quality and experience standards, and plans must do more with less.

The CMS Star Ratings system measures performance across quality of care, member experience, preventive care, chronic condition management, medication adherence, and complaints or access issues, and is used by beneficiaries to compare plan quality. Higher ratings can significantly affect plan revenue through quality bonus payments, rebates, and enrollment growth, making Star Ratings performance a core strategic priority.

Industry data supports that these ratings truly matter: In the recently released 2026 Star Ratings, approximately 64% of enrollees were in plans rated four stars or higher, and plans with better scores stand to benefit not only in quality bonus payments but in member retention and competitive positioning.

Member Engagement Challenges that Hurt Star Ratings

Plans are under pressure to deliver outcomes across multiple fronts that directly influence Star Ratings performance:

• Improve member experience: CAHPS scores hinge on whether members feel supported, understood, and able to use their benefits easily
• Manage chronic conditions at scale: Clinical and adherence measures depend on sustained, behavior-driven engagement, not one-time outreach
• Drive preventive care and adherence: Screenings and healthy behaviors require timely nudges tied to real member actions
• Control costs without diluting impact: Benefits that aren’t used, trusted, or targeted fail to justify their investment

Yet many plans still rely on static benefit designs and generic engagement models, including broad campaigns, uniform rewards, and disconnected supplemental benefits programs that treat all members the same.

The result: Low utilization, diluted engagement, benefit leakage, and missed opportunities to influence the Star measures that matter most.

How Targeted Member Engagement Improves Star Ratings and Outcomes

Broad, generic outreach may tick the box for sending communications, but it doesn’t move the needle on the measures that CMS actually rewards. What moves Star Ratings performance is engagement that is timely, relevant, tied to real member behavior, and delivered through the channels members actually use.

Targeted engagement means: Delivering the right message, through the right channel, at the right time, about the right benefit, based on who the member is and what they’re likely to need next.

This is proven to be a more effective approach than undifferentiated campaigns because it anticipates individual care patterns and connects engagement to real, measurable actions tied to quality outcomes.

Ways Lynx Helps Medicare Advantage Plans Improve Star Ratings Performance

Lynx is purpose-built to help Medicare Advantage plans turn member engagement into measurable outcomes that support Star Ratings performance. Rather than relying on static benefits and one-size-fits-all rewards, Lynx enables precision engagement through real-time infrastructure, personalized benefit controls, and a unified member spend experience, so engagement strategies stay tightly aligned to quality priorities, CAHPS measures, and evolving CMS performance goals.

At Lynx, we view CMS Star Ratings as the outcome of how effectively plans engage members through the benefits they use every day. When engagement is targeted, relevant, and embedded into real member behavior through a unified experience across flex cards, rewards, and curated benefits like OTC, food, and wellness, it drives higher utilization, stronger trust, and healthier behaviors that translate into better quality outcomes.

The Lynx Platform Capabilities Driving Star Rating Performance

Customizable SKU-Level Approved Product Lists (APLs) for Precision Benefits

Lynx delivers personalized benefit experiences by consolidating flexible spend (flex cards), restricted supplemental benefits, and rewards into a single, intuitive card and digital wallet, powered by real-time eligibility and spend controls. Members no longer need to navigate multiple cards, portals, or rules. One unified experience reduces friction, builds trust, and drives engagement.

Whether shopping in-store across 60,000+ merchants in the Lynx network or via a curated, plan-branded e-commerce experience, benefits are personalized based on member eligibility, history, and behavior.

Plans can define supplemental benefits with SKU-level precision, ensuring product catalogs and purchases align to specific conditions, preventive goals, and population needs. Instead of broad categories or vendor-defined lists, plans control which products are available, and to whom.

For example, a member with diabetes can use their monthly benefit spend on items that support their care journey, such as diabetic socks, alcohol prep pads, or glucose supplies, rather than non-supportive products. This precision helps plans stay CMS-compliant, ensures benefits are used as intended, and provides real-time validation for every transaction against approved product lists (APLs), eligibility rules, and benefit intent, giving members confidence and reinforcing trust that what they’re trying to purchase is covered.

Personalized Benefits and Rewards that Support Healthy Behaviors

CAHPS scores, a critical component of Star Ratings, reflect whether members feel informed, supported, and able to use their benefits effectively. Lynx goes beyond surface-level targeting, tailoring benefits and reward programs based on member eligibility, history, behavior, and care needs.

By aligning outreach and benefits to each member, engagement feels credible, timely, and meaningful rather than transactional. For example, a member with high blood pressure could receive a targeted reward for completing an at-home blood pressure test and attesting to the results, then order low-sodium meal kits delivered to their home, supporting both condition monitoring and healthy behavior adoption.

Lynx supports a true omnichannel engagement strategy, meeting members where they are:

• Email for education and program highlights
• Text messages for timely nudges and reminders
• Hard-copy mailers for members who prefer physical communications
• Portal notifications + app push messages to reach members digitally wherever they engage
  
  

Members receive the right message at the right moment, with benefit options and rewards that directly support their health goals. This multi-modal approach consistently reinforces benefits and incentives, increases utilization, helps close care gaps, and drives the healthy behaviors that influence CAHPS scores and other Star measures. By embedding rewards and incentives into the member experience, Lynx transforms benefits into a strategic lever for quality improvement, member satisfaction, and trust.

Maximizing Member Touchpoints Across the Benefit Journey

With Lynx, engagement isn’t limited to isolated campaigns. Every interaction with benefits becomes an intentional opportunity to reinforce healthy behaviors, build trust, and improve outcomes. By combining SKU-level precision with Approved Product Lists (APLs) and personalized rewards and incentives within a unified flex card and wallet experience, Lynx ensures that each touchpoint is meaningful and connected to the member’s overall care journey.

Members are guided seamlessly through their benefits in ways that feel natural and supportive: from purchasing relevant OTC items or preventive care products, to redeeming rewards, to discovering curated wellness offerings in a plan-branded e-commerce environment. Every interaction is validated in real-time against eligibility rules and approved product lists, so members can act confidently, knowing their choices align with their health goals.

By layering touchpoints across multiple channels, Lynx turns each interaction into a strategic lever for quality improvement. Engagement becomes cumulative, reinforcing health behaviors, increasing benefit utilization, and supporting CMS Star measures and care gap closures.

Using Personalized Benefits and Rewards to Improve Star Ratings

With Lynx, targeted member engagement isn’t a campaign, it’s an operating model. When benefits are intentional, personalized, and easy to use, engagement follows—and so do better outcomes.

Lynx helps Medicare Advantage plans transform and unify supplemental benefits, flex cards, and rewards into powerful levers for quality improvement. The result is higher benefit utilization, healthier member behaviors, and engagement strategies that directly support CMS Star Ratings and long-term plan performance.

If improving Star Ratings performance is a strategic priority, it’s time to modernize how benefits, rewards, and engagement work together.

Lynx is built to help health plans do exactly that.