Why CMS Should Include Digital Literacy Metrics in Medicare Advantage Star Ratings

Because the marketplace alone — insurance companies, health systems and providers, VCs and other stockholders — may not deliver solutions that makes the patient journey easier.

Analysts at J. D. Power released the 2025 Healthcare Digital Experience Study on April 8, 2025. On a scale of 1 to 1000, commercial health plans received experience score of 635 out of 1,000 and Medicare Advantage Plans received 597 out of 1,000. The fact that Medicare Advantage plans scored worse suggests that the status quo is failing our beloved senior populations, the group that requires the most attention and best care.

Altogether, healthcare digital experience was the worse among all industries surveyed. And within healthcare, some organizations are doing far better than others. But this is neither new nor surprising. We’ve seen this movie before.

The HITECH Act, part of the American Recovery & Reinvestment Act of 2009, provided the opening that saw health tech companies build robust platforms with features that optimized productivity for health systems but no guide or support for the patient. Patients, their families and caregivers were left juggling multiple portals on their own.

We see a repetition of the same cycle with AI, we see VCs and legacy tech companies pushing most startup founders to focus on AI that boosts back-end efficiency, while patients remain burdened with navigating siloed, disconnected systems.

Without intervention from CMS, the marketplace will continue to prioritize the operational needs of health systems and health plans, while patients are left to experience declining outcomes.

U.S. Centers for Medicare and Medicaid Services (CMS) Star Ratings are critical to driving member retention and financial reimbursement. The higher a Star Rating is, the higher the reimbursement rate a plan receives. By including Digital Literacy metrics in their Star Rating, healthcare providers and insurers will be motivated to do more to improve healthcare digital experiences.

Healthcare providers and health plans can begin with basic offering like in-home setup of digital health devices and in-person one-on-one training to help patients with:

·       Using smartphones or tablets to access health information

·       Navigating member portals and electronic health records (EHRs)

·       Participating in virtual doctor visits

·       Using wearable devices to track health metrics

·       Using medical devices at home

·       Navigating health-related websites

·       Regular check-ins to ensure ongoing comfort with digital tools

This is beneficial for providers, payers, and members alike. Healthcare providers benefits from having a system that improves patient self-care in the face of staff shortages, increased patient satisfaction and reduced readmissions. Members have better access to tools that gives them greater access to the care they need, leading to better outcomes. Payers are able to attract and retain more members by providing a consistently positive experience.

Reaching for the Stars

A higher star rating is attainable for any healthcare organization. But the marketplace alone may not deliver solutions that makes the patient journey easier. CMS needs to push healthcare organizations to go beyond their current offerings. By including digital literacy in Star Rating.

At Visbiliti Health, we help health systems and health plans to empower their consumers to better manage their health and safety in a digital world.