Anna - Improve Medicare Advantage STAR Ratings Through SMS

Calculate Your ROI with Anna

See the comprehensive impact Anna can have on your Medicare Advantage plan

Your Plan Details

Number of Medicare Advantage Members Enter your total MA membership

Current Overall STAR Rating Used to calculate potential bonus revenue

Current Annual Member Churn Rate

Percentage of members who leave your plan annually

Member Engagement Projections

Based on pilot data, members engage differently with various outreach types

Overall SMS Response Rate

Medication Reminder Response: 42%

AWV Scheduling Response: 36%

Post-Discharge Response: 48%

Anna's Proven Impact Ranges

Adjust to model different scenarios. Impact plateaus at higher performance levels.

Medication Adherence Improvement

Conservative: 5% Expected: 7.5% Best Case: 10%

7.5% improvement

Annual Wellness Visit Completion Improvement

Conservative: 5% Expected: 10% Best Case: 15%

10% improvement

30-Day Readmission Reduction

Conservative: 5% Expected: 7.5% Best Case: 10%

7.5% reduction

Member Churn Reduction

Conservative: 10% Expected: 15% Best Case: 20%

15% reduction in churn

Your Projected Annual Results

Show all scenarios side-by-side

Total Revenue

Total Savings

Anna Investment

Net Benefit

Impact by Category

Revenue Impacts

STAR Rating Bonus $0

No bonus eligibility

Member Retention Revenue $0

0 members retained

AWV Revenue $0

0 additional AWVs

Cost Savings

Medication Adherence Savings $0

0% improvement

Readmission Prevention $0

0 readmissions prevented

Care Team Efficiency $0

0 FTE hours saved

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ROI Calculator Methodology

1. Revenue Impact Calculations

1.1 STAR Rating Revenue (Quality Bonus + Rebate)

Formula:


                                STAR Improvement = Σ(Improvement% × Measure Weight)

                                Quality Bonus = Members × $14,000 × 5% (if crossing 4-star threshold)

                                Rebate Increase = Estimated Savings × (New Rebate% - Current Rebate%)

Key Assumptions:

CMS Quality Bonus: 5% of benchmark for plans ≥4.0 stars
Rebate percentages: 3.5★=50%, 4.0★=65%, 4.5★=70% of savings
Measure weights: Medication Adherence (0.12), AWV (0.08), Readmissions (0.06)
Maximum STAR improvement capped at 0.5 stars

1.2 Member Retention Revenue

Formula:


                                Retained Members = Total Members × Churn Rate × Churn Reduction%

                                Retention Revenue = Retained Members × (LTV - Acquisition Cost) / LTV Years

Key Assumptions:

Member Lifetime Value (LTV): $14,000 × 3.5 years = $49,000
Acquisition cost: $750 per new member
Plans typically backfill churned members, so we calculate net value

1.3 Annual Wellness Visit (AWV) Revenue

Formula:


                                Additional AWVs = AWV-Engaged Members × AWV Improvement%

                                AWV Revenue = Additional AWVs × ($175 CMS payment + $1,500 HCC value)

Key Assumptions:

CMS payment per AWV: $175
Average HCC risk adjustment value captured: $1,500
60% of SMS-engaged members respond to AWV scheduling

2. Cost Savings Calculations

2.1 Medication Adherence Savings

Formula:


                                Eligible Members = Med-Engaged Members × 65% (chronic med prevalence)

                                Effective Improvement = Base Improvement × Diminishing Returns Factor

                                Savings = Eligible Members × Effective Improvement × $15 per point

Key Assumptions:

65% of Medicare members are on chronic medications
$15 saved per percentage point improvement in adherence
70% of SMS-engaged members respond to medication reminders
Diminishing returns: 75% effectiveness above 75% baseline, 50% above 85%

2.2 Readmission Prevention

Formula:


                                At-Risk Members = Discharge-Engaged Members × 20% (admission rate)

                                Baseline Readmissions = At-Risk Members × 18% (readmission rate)

                                Prevented Readmissions = Baseline × Readmission Reduction%

                                Savings = Prevented Readmissions × $15,000

Key Assumptions:

20% annual hospital admission rate
18% 30-day readmission rate baseline
$15,000 average cost per readmission
80% of SMS-engaged members respond to discharge follow-ups

2.3 Care Team Efficiency

Formula:


                                Hours Saved = Total Engaged Members × 2 hours/year

                                FTE Equivalent = Hours Saved / 2,080 hours

                                Savings = Hours Saved × $35/hour (fully loaded cost)

Key Assumptions:

2 hours saved annually per engaged member
$35/hour fully loaded care team cost
2,080 working hours per FTE annually

3. Engagement & Response Rates

Based on pilot data, different message types achieve different response rates:

Medication Reminders: 70% of overall engagement rate
AWV Scheduling: 60% of overall engagement rate
Post-Discharge Check-ins: 80% of overall engagement rate

Example: If overall SMS engagement is 60%, then 42% respond to medication reminders, 36% complete AWV scheduling, and 48% respond to discharge follow-ups.

4. Overlap Adjustments

To prevent double-counting benefits, we apply the following adjustments:

Adherence → Readmissions: 30% of adherence savings already prevent readmissions
STAR → Retention: 25% of STAR bonus value already captured in retention
AWV → Adherence: 15% of AWV value improves medication tracking

Total Value = Revenue + Savings - Overlap Adjustments

5. Program Investment & ROI

Anna Program Cost:

Annual Investment = Members × $1.00 PMPM × 12 months

Return on Investment:


                                Net Benefit = Total Value - Anna Investment

                                ROI% = (Net Benefit / Anna Investment) × 100

6. Scenario Modeling

Metric	Conservative	Expected	Best Case
Medication Adherence Improvement	5%	7.5%	10%
AWV Completion Improvement	5%	10%	15%
Readmission Reduction	5%	7.5%	10%
Member Churn Reduction	10%	15%	20%

7. Data Sources & References

CMS STAR Ratings: CMS Part C & D Performance Data
MA Payment Rates: Based on 2025 CMS Medicare Advantage ratebook
HCC Risk Adjustment: CMS Risk Adjustment methodology
Readmission Costs: Healthcare Cost and Utilization Project (HCUP) data
Medication Adherence Impact: Pharmacy Quality Alliance studies
Engagement Rates: Anna Health pilot program data (n=2,000 members)

8. Limitations & Disclaimers

Results are estimates based on industry averages and pilot data
Actual results will vary based on member population characteristics
STAR rating improvements typically take 12-18 months to fully realize
Some benefits may take multiple years to achieve
Calculations assume consistent program engagement over time
Does not account for potential competitive responses or market changes

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Calculate Your ROI with Anna

Your Plan Details

Member Engagement Projections

Anna's Proven Impact Ranges

Your Projected Annual Results

Total Revenue

Total Savings

Anna Investment

Net Benefit

Impact by Category

Revenue Impacts

Cost Savings

ROI Calculator Methodology

1. Revenue Impact Calculations

1.1 STAR Rating Revenue (Quality Bonus + Rebate)

1.2 Member Retention Revenue

1.3 Annual Wellness Visit (AWV) Revenue

2. Cost Savings Calculations

2.1 Medication Adherence Savings

2.2 Readmission Prevention

2.3 Care Team Efficiency

3. Engagement & Response Rates

4. Overlap Adjustments

5. Program Investment & ROI

6. Scenario Modeling

7. Data Sources & References

8. Limitations & Disclaimers

Why Medicare Advantage Plans Choose Anna

STAR Rating Focus

Medicare Population Expertise

Rapid Implementation

Drive Impact Across Key STAR Measures

Medication Adherence

Preventive Care Reminders

Post-Discharge Follow-up

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