The Medication Adherence Problem
Non-adherence is the single largest driver of preventable healthcare costs in the United States.
Why Star Ratings Matter
The 4-star threshold is the most important financial milestone for any Medicare Advantage plan.
The Medicare Advantage Star Rating system directly impacts revenue through quality bonus payments. Plans rated 4 stars or above receive a 5% bonus on their benchmark payments. For a plan with 100,000 members, this can mean tens of millions in additional revenue.
The Three Measures That Matter Most
Part D medication adherence measures are triple-weighted in the Star Rating calculation.
Triple-weighted — these 3 Part D adherence measures account for approximately 1/3 of your entire Part D Star Rating. Improving medication adherence is the single highest-leverage action for Star Rating improvement.
How AdherePod Helps
A voice-native device designed from the ground up for the populations that need it most.
Voice-native design for elderly and low-literacy populations — the hardest-to-reach members
Daily medication reminders targeting PDC >= 80% threshold
Specifically designed for diabetes, hypertension, and cholesterol medications
No smartphone or app literacy required
Proactive adherence tracking and caregiver alerts
Plug-and-play device that works out of the box
Return on Investment
Improving medication adherence from 70% to 80% PDC across diabetes, hypertension, and statin measures could improve your Star Rating by 0.5–1.0 stars.
At 4+ stars, that's approximately $50M+ in additional annual quality bonus payments.
Estimates based on publicly available CMS quality bonus payment data. Actual results vary.
Flexible Pricing
Choose the model that works for your plan — or combine both.
$3–$10 PMPM
Predictable, budgetable cost depending on population size and scope.
- Includes device, platform, and ongoing support
- Revenue scales with enrolled member count
- Simple, predictable budget line item
Pay nothing until adherence metrics improve
Tied to specific measurable outcomes:
- PDC improvement — increase Proportion of Days Covered toward the 80% threshold across D08, D09, D10. Research shows increasing diabetes drug adherence from 50% to 100% reduces hospitalizations by 23.3% and ER visits by 46.2%.
- Star Rating improvement — payment tied to measurable gains. These 3 Part D adherence measures account for 11.1% of overall Star Rating weight in 2026. Moving from 3 to 4 stars increases plan revenue 13–17%.
- Hospitalization reduction — reduced ER visits and inpatient admissions attributable to non-adherence. Non-adherent patients require 3+ extra medical visits/year, adding $2,000+ per patient annually.
- Medication gap closure — percentage of identified adherence gaps closed within a measurement period
Adherence interventions show benefit-cost ratios of 13.5:1 (hypertension), 8.6:1 (diabetes/heart failure), and 3.8:1 (statins). Statin adherence alone saves $157 PMPM in total costs.