Transform Digital Friction Into Member Confidence and Stars Will Follow
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Across the Medicare Advantage landscape, plans are racing to improve Star Ratings, reduce churn, and meet CMS digital equity requirements. Yet the biggest barrier isn’t technology — it’s activation. Millions of members are unable to use the very tools designed to improve their experience and health. GetSetUp bridges that gap through peer-led digital health education, turning confusion into confidence and powering measurable gains in engagement, retention, and Star performance.
Even the most sophisticated digital tools can’t move Star Ratings if members don’t use them. To understand where activation breaks down, it helps to look at the most costly friction points facing plans today.
The five pain points below reveal why traditional engagement efforts fall short and how GetSetUp’s peer-led approach activates members where technology alone cannot.
1. Low Digital Activation → Lost ROI
Most plans invest millions in portals, apps, and telehealth, but “Only 12% of adults in the United States have the health literacy skills needed to navigate complex health information in the digital age,” according to NCQA. Older adults want to engage but lack digital confidence and guided support.
Evidence:
- CMS Digital Equity Initiative (2024) calls for measurable digital literacy improvement.
- GetSetUp members show + 68% increase in digital confidence and +72% increase in Medicare understanding.
- Peer-led digital education builds lasting skills and confidence for higher ROI, faster digital adoption, and greater satisfaction across plan technologies.
Impact: Low activation stalls self-service, drives up call-center volume, and undermines every technology investment.
2. Declining Star Ratings → Lost Revenue
CAHPS measures now carry four times the weight in Star Ratings, meaning experience drives outcomes. Yet member confusion with portals and benefits — not clinical care — remains the top cause of low satisfaction and bonus loss.
Evidence:
- Each 0.1 drop in Star Ratings can reduce CMS bonus payments by millions.
- GetSetUp boosts CAHPS measures like 'Ease of Getting Care' and 'Care Coordination.'
- A 10% lift in digital engagement can increase Star Ratings by 0.1–0.2 points.
Impact: When members can’t navigate your tools, they give lower satisfaction scores regardless of care quality.
3. High Churn & Low Retention → Rising Costs
Members don’t stay when they don’t feel supported. Frustration with digital access and benefit navigation leads directly to plan switching.
Evidence:
- Digital engagement improves satisfaction and reduces voluntary disenrollment by up to 30%.
- It costs 5–10x more to replace a member than to retain one.
- Digitally confident members are twice as likely to complete preventive care visits and wellness programs.
Impact: Confused members leave. Confident members stay and advocate for your plan.
4. Operational Inefficiency → Hidden Administrative Waste
Every “How do I log in?” or “How do I schedule a visit?” call costs $8–$12 in staff time. When members can’t self-serve, support teams pay the price with thousands of routine tech questions draining productivity and inflating administrative overhead.
Evidence:
- Administrative efficiency gains reduce inbound calls, scheduling burdens, and operational costs by 10–30% for digitally active members.
- Continuous digital education delivers 25–50% higher ROI compared to one-time onboarding, sustaining efficiency gains over time
- Digitally confident members eliminate the “navigation barrier,” using telehealth, portals, and preventive care programs more effectively.
- Combined efficiencies yield a 6–18% total plan-spend reduction ($888–$2,544 PMPY).
Impact: You’re paying twice: once for the technology, and again for the help desk. Peer-led activation turns your self-service tools into actual cost savings.
5. Competitive & Compliance Pressure → Strategic Risk
CMS and NCQA are linking Star Ratings, compliance, and digital equity. Plans that can’t activate older members risk both penalties and lost market share.
Evidence:
- CMS’s Framework for Health Equity 2024–2030 includes digital access as a measurable health disparity.
- NCQA’s 2025 HEDIS updates emphasize member experience and equitable engagement.
- Plans leveraging engagement data to increase digital adoption, retention, and CAHPS/HEDIS completion rates gain measurable financial and Star Rating advantages
Impact: In today’s landscape, digital activation isn’t a compliance box, it’s a competitive differentiator. The plans that master digital activation today will define the Star leaders of tomorrow.
The GetSetUp Solution: Peer-led Digital Health Activation for Older Adults
GetSetUp delivers trusted, scalable member activation through live and on-demand learning built for Medicare Advantage members - older adults who need digital, health, and plan confidence to fully engage.
Members build digital, health, and plan literacy through peer-led instruction, AI-assisted navigation, and community reinforcement creating lasting confidence and measurable engagement, not just participation.
What Makes It Different:
Peer-Led Trust: Older adults learn best from relatable peers — not professionals.
Scalable Infrastructure: 2,500+ active classes mapped to Star measures, continuously updated and reaching millions of members — the largest peer-led network of its kind.
Evidence-Based Outcomes:
+68% digital confidence gain→ telehealth-ready members.
+72% improvement in plan understanding → less confusion, higher satisfaction.
+47% increase in self-management confidence → healthier eating and habits.
63% of participants report taking a real-world action after class, such as using a new digital tool, applying a health behavior, or completing a recommended activity (based on GetSetUp post-class survey data)
Potential Partner Impact Based-on Industry Research:
6-18% reduction in plan spend per engaged member ($888-$2,544 PMPY).
10-30% fewer inbound calls and admin tasks
Up to 0.2 Star Rating improvement through higher CAHPS and HEDIS completion
Compliance Alignment: Supports CMS’s Digital Equity and Health Literacy mandates giving plans a reportable, measurable activation model aligned with federal health equity goals.
Bottom Line:
Digital activation isn’t a technology issue—it’s a member engagement opportunity. GetSetUp helps Medicare Advantage plans transform digital friction into measurable results: higher CAHPS scores, stronger retention, and lower administrative costs.
Let’s explore how peer-led activation can turn every digital investment into Star Rating gains and real member impact.
Bring GetSetUp to your organization
We partner with Medicare Advantage plans, dual eligible plans, healthcare providers, Departments of Health & Human Services, Government aging services and more.
