The member benefit that pays for itself.
Tabula improves the Star Rating measures worth tens of millions in annual CMS Quality Bonus Payments — by giving your members a health companion that actively closes care gaps, improves medication adherence, and creates the best healthcare experience of their lives.
Avg HCC revenue recovered per 10K members
Star Rating improvement pathway
Annual care coordination savings
Reduction in incomplete intake forms
Six ways Tabula moves your Star Rating.
01
Improve medication adherence
Surescripts-verified medication records and refill reminders drive the PQA adherence measures that are among the most heavily weighted in Star Ratings calculations.
02
Close HEDIS care gaps
Tabula knows which members are overdue for diabetic eye exams, HbA1c tests, cholesterol panels, and other HEDIS measures — and prompts them to close the gap before the measurement period ends.
03
Improve CAHPS member experience
Members who never fill out a form, receive pre-visit briefings, and get plain-language visit summaries report dramatically better care experiences — directly measured in CAHPS surveys that determine Star Ratings.
04
Medication reconciliation post-discharge
Accurate real-time medication records at post-discharge visits prevent the errors that cause readmissions — closing one of CMS's most closely tracked Star Rating measures.
05
Reduce care coordination burden
Care managers spend less time chasing records and calling members. Tabula delivers accurate member health data automatically — freeing your team for higher-value interventions.
06
RADV audit protection
Complete clinical documentation at the point of care means audit-defensible records. With RADV audits resumed covering payment years back to 2018, documentation completeness is a financial priority — not just a quality metric.
THE FINANCIAL CASE
The difference between 3.5 and 4.0 Stars.
CMS distributed $10 billion in Quality Bonus Payments in 2022 — averaging $352 per enrolled member per year for plans achieving 4+ Stars. Plans with 4+ Stars also receive a 5-10% benchmark increase on every dollar CMS pays them.
For a plan with 50,000 members, the difference between 3.5 and 4.0 Stars is worth $17.6 million per year. Tabula costs a fraction of that.
Request a PilotTHE PLAN ADMIN PORTAL
Everything your Quality team needs. In one place.
When you partner with Tabula, your team gets a dedicated real-time dashboard built specifically for Medicare Advantage quality management.
Member Population Database
Complete database of all your Tabula-enrolled members. Searchable, filterable by composite score, care gaps, or revenue at risk. See every member's open gaps and recommended next action at a glance.
Composite Opportunity Scoring
Every member and every gap scored by Urgency (40%), Profitability (35%), and Ease to Close (25%). Automatically prioritizes who your care coordinators should contact first for maximum Star Rating impact.
Star Rating Simulator
Interactive sliders for every HEDIS measure. See in real time how closing different percentages of gaps moves your projected Star Rating and QBP revenue. Built for your quality meetings and board presentations.
Outreach Campaign Builder
Select a HEDIS measure, filter your member population, compose personalized SMS and in-app messages, and launch targeted outreach campaigns at scale. Track response rates and gap closures per campaign.
Monthly Quality Reports
Auto-generated board-ready reports showing HEDIS measure progress, Star Rating trajectory, HCC revenue identified, outreach performance, and next month's recommended priorities. Exportable to PDF, email, or Excel.
HCC Revenue Recovery
Tabula's medication-implied diagnosis detector identifies members whose medication lists suggest undocumented HCC conditions. Flags revenue recovery opportunities with estimated PMPY impact per member.
SMS Outreach at Scale
Send personalized care gap reminders, appointment preps, and medication refill nudges via SMS to your entire member population. Messages include one-tap scheduling links and are tracked for response and gap closure.
Geriatric Risk Intelligence
For members 65+, Tabula automatically scores anticholinergic cognitive burden, flags Beers Criteria medications, detects polypharmacy, and correlates cognitive decline with medication timelines — surfaced in every pre-visit brief.
Everything is calculated from real FHIR health record data — not claims estimates. Tabula's clinical intelligence engine runs HEDIS rules, PDC calculations, and HCC detection directly against member records pulled from connected EHRs via Health Gorilla and Surescripts.
THE MEASURES THAT MATTER
Exactly which Star Rating measures Tabula improves.
Star Ratings are calculated from specific HEDIS clinical measures and CAHPS survey scores. Here is precisely where Tabula creates measurable impact.
| MEASURE | DOMAIN | HOW TABULA HELPS | WEIGHT | TIMELINE |
|---|---|---|---|---|
| Medication Adherence — Diabetes | Part D (PQA) | Surescripts refill tracking and patient reminders drive consistent fill rates | Triple-weighted ★★★ | Immediate |
| Comprehensive Diabetes Care (HbA1c) | Part C (HEDIS) | Care gap alerts prompt annual HbA1c testing for all diabetic members | Standard ★ | 3-6 months |
| Controlling Blood Pressure | Part C (HEDIS) | Complete medication records at every visit support accurate BP management documentation | Standard ★ | 3-6 months |
| Medication Reconciliation Post-Discharge | Part C (HEDIS) | Accurate real-time medication lists at post-discharge visits close this measure automatically | Double-weighted ★★ | Immediate |
| CAHPS Member Experience | Survey | Pre-visit briefings and frictionless intake drive dramatically higher member satisfaction scores | Triple-weighted ★★★ | 6-12 months |
| Care Gap Closure (Preventive) | Part C (HEDIS) | Proactive care gap alerts for eye exams, bone density, cholesterol panels, and more | Standard ★ | 3-6 months |
| Breast Cancer Screening (BCS-E) | Part C (HEDIS) | Care gap alerts prompt scheduling for overdue mammograms. Tabula tracks days overdue and generates outreach automatically. | Triple-weighted ★★★ | Immediate |
| Medication Adherence — Statins (MAS) | Part D (PQA) | Refill tracking and SMS reminders drive consistent statin fill rates for cardiovascular patients. | Triple-weighted ★★★ | Immediate |
| Medication Adherence — RAS Agents (MAR) | Part D (PQA) | ACE inhibitor and ARB adherence tracked via Surescripts and flagged when PDC drops below 80%. | Triple-weighted ★★★ | Immediate |
| Annual Wellness Visit (AWV) | Part C (HEDIS) | Tabula identifies members without a completed AWV and generates scheduling outreach with one-tap booking. | Standard ★ | 1-3 months |
Triple-weighted measures have 3× impact on overall Star Rating. Double-weighted measures have 2× impact. Source: CMS Star Ratings Technical Notes.
A 90-day pilot in three phases.
Phase 1
Connect
Onboard 1,000 members. Connect insurance + top three portals.
Phase 2
Measure
Track HCC recapture and care gap closure week over week.
Phase 3
Scale
Roll out to full population with co-branded experience.