Download This Blueprint to Learn:
 

• Assess whether your plan is prepared for 2026 requirements tied to D-SNP and Medicare Advantage Star Ratings, member engagement, outcomes, and SDoH support.

• Pinpoint where members are falling through the cracks across outreach, care coordination, quality performance, and documentation.

• Confirm that your current virtual care strategy is reaching high-risk members consistently and improving participation across priority populations.

• Evaluate whether physical, behavioral, and social care workflows are aligned to close gaps and improve member outcomes.

• Check that your plan has mobile-first tools, live coordinators, and remote monitoring in place to support higher engagement and faster intervention.

• Make sure multilingual, culturally responsive support is built into your model so underserved and high-risk members are not left behind.

• Monitor engagement, clinical outcomes, hospitalizations, ER use, and financial impact to confirm the program is delivering value.

• Review whether your workflows, reporting, and protocols are aligned with current CMS deadlines, Star requirements, and certification expectations.

About the Checklist

This checklist helps health plan leaders evaluate whether they are fully prepared for the 2026 CMS environment and the growing demands tied to Star Ratings, member experience, and quality performance. It focuses on the operational steps needed to improve engagement, support vulnerable and high-risk members, strengthen clinical and financial outcomes, and align programs with evolving CMS expectations, reporting requirements, and equity goals.