One story, two tracks, timed to the CMS release. A head start for the group to shape: the chain from queue to rating, who owns it in each account, a starting draft of the sequence, and the path to an October launch.
| Health plans (Medicare Advantage) | Health systems (Cleveland Clinic and peers) | |
|---|---|---|
| The rating | CMS Part C and D Star Ratings, 2027 ratings post early October | CMS Overall Hospital Star Rating, plus the ambulatory CAHPS surveys and the quality terms in Medicare Advantage risk contracts |
| Where the queue shows up | Complaints about the plan, members choosing to leave, the CAHPS customer service score. All three are live in the 2027 ratings. CMS also holds plan call centers to a two minute average hold and a five percent disconnect rate, checked by secret shopper every quarter | The ambulatory CAHPS survey asks patients how often they got an appointment and an answer as soon as they needed. HFMA sets the access center benchmark at under five percent abandoned calls, and its 2024 survey average sat just above that |
| The money | Four stars or better earns the five percent benchmark bonus and a larger rebate share. KFF puts the 2026 bonus program above $13B | Patient experience is about a quarter of the Hospital Value Based Purchasing score, funded by a two percent payment withhold. Systems carrying Medicare Advantage risk also share in the plan's star performance |
| The line to keep | Queue performance feeds measures CMS scores and pays on | The hospital star rating is built on the inpatient HCAHPS survey and has no phone or queue measure. The provider story runs through access, ambulatory experience scores and risk contracts |
| Who feels it | Stars and Quality, Member Services, Medicare finance | Patient Access, Patient Experience, Population Health and value based care |
Cleveland Clinic sits in the second column with one addition: it took on Medicare Advantage delegated risk agreements in January 2025 and runs a co-branded plan with Aetna, so plan star measures now reach its own revenue. Which program Cleveland Clinic has in mind when it says star ratings is the first thread below.
Sources: CMS CY2027 final rule fact sheet (Apr 2 2026), CMS 2027 Star Ratings measures list, 42 CFR 422.111(h), KFF 2026 quality bonus analysis, CMS Overall Hospital Star Rating 2026 methodology, AHRQ CG-CAHPS, HFMA patient access KPIs, Becker's coverage of Cleveland Clinic 2025 results.
| Seat | Health plans | Health systems |
|---|---|---|
| Owns the rating | VP or SVP Stars and Quality, Chief Medicare Officer | Chief Quality Officer, Chief Safety, Quality and Experience Officer |
| Owns the experience score | VP Member Experience, CAHPS program lead | Chief Patient Experience Officer |
| Owns the queue | VP Member Services, Director Contact Center Operations, WFM lead | Executive Director Patient Access or Access to Care, Director Access Optimization, Director Call Center Operations |
| Owns the money | Medicare CFO, VP Medicare Finance | VP Population Health or Value Based Care, managed care contracting, revenue cycle |
How the target list gets its owners, in order:
Unique insight wins. Every vendor emails a plan about Stars in October. What only we can send is the plan's own 2027 movement on the service measures, computed at parent level from the CMS file within 48 hours of release, next to the queue layer that acts on it. For customers the unique piece is stronger: their own Intradiem usage data beside their own measures.
Every advantage decays. Last year's hook has an expiry date. CMS finalized removing the call center interpreter and TTY measures starting with the 2028 ratings, so the 2027 release is the last one that counts them, and the copy moves to the measures that stay. The release-week window is just as perishable: by November the inbox is full of Stars notes.
Iteration speed beats decay. Two variants on every Email 1, a first read on replies inside a week, swaps made wave by wave. The refresh job, the Clay tables and the lemlist drafts give us a head start here: a new angle becomes a same-day change, and the loop keeps getting tighter as we run it.
A starting draft for Cheryl and Sierra to reshape. It follows the Sep 3 doctrine shape (three emails, two LinkedIn touches, one question per message, no calendar ask in Email 1). The Back Office Optimizer framework ran five emails and three LinkedIn touches, and extending to that shape is an easy add once the direction is set. Tokens in double braces fill from the CMS release and the Clay table.
Email 1. Subject: {{plan_name}} and the 2027 stars
Hi {{firstName}},
CMS posted the 2027 Star Ratings {{release_day}}, and {{plan_name}}'s book looks to have landed near {{stars_2027}}. You'll know the exact picture better than I do.
The service side of that number gets made on the days call volume runs past the forecast.
That's what Intradiem works on. Our new Queue Optimizer sits on top of the ACD and WFM you already run, watches every queue against its service level target, and recommends the agent moves before a queue slips, with your team approving them.
It reaches beta this quarter. Worth a conversation on what a pilot across your member services queues could look like?
Nathan
LinkedIn connect note (day 2).
Hi {{firstName}}, sent you a note by email about {{plan_name}}'s 2027 stars and the service side of the number. Thought this might be a quicker way to connect. Nathan
Email 2 (day 4, reply in thread).
{{firstName}}, one more angle. Open enrollment starts October 15, the stretch when member services queues carry the most volume and the two minute hold standard is hardest to keep.
Humana has run Intradiem since 2020 and has it on the record: handle time down 45 seconds and a 7X return five years in. Queue Optimizer is new, so it has no numbers of its own yet. A pilot is how it earns them, on your queues and your targets.
How is your team covering the enrollment peaks today?
Nathan
LinkedIn message (day 7).
Thanks for connecting, {{firstName}}. The short version of my note: the service side of {{plan_name}}'s 2027 stars gets made on the days volume beats the forecast. Intradiem's new Queue Optimizer flags the queues about to slip and recommends the agent moves before they do, on top of the ACD and WFM you run. Worth a conversation on what a pilot across your member services queues would need?
Email 3 (day 11, breakup).
{{firstName}}, I'll leave it here. If the 2027 numbers put the service measures back on your desk before the measurement year closes, that's the moment to pick this up. Hope open enrollment runs smoothly for the team.
Nathan
Email 1. Subject: the phone side of access
Hi {{firstName}},
HFMA sets the access center bar at under five percent of calls abandoned, and its 2024 survey put the average just above it.
That's the gap Intradiem works on. Our new Queue Optimizer runs on top of your phone system and WFM, tracks each scheduling queue against its target, and flags the agent move before a queue slips. Your team approves each one.
It reaches beta this quarter. Worth a conversation on how {{company}} covers the peak days now?
Nathan
LinkedIn connect note (day 2).
Hi {{firstName}}, I emailed you about the phone side of patient access at {{company}}. Connecting here in case it's the easier place to pick it up. Nathan
Email 2 (day 4, reply in thread).
{{firstName}}, one more angle. The CAHPS surveys your medical groups field ask patients how often they got an appointment and an answer as soon as they needed. That score gets made in the scheduling queue.
Humana has run Intradiem since 2020 and has it on the record: handle time down 45 seconds. Queue Optimizer is new, so its own numbers will come from pilots.
Is the access queue on the agenda for your experience and quality teams this year?
Nathan
LinkedIn message (day 7).
Good to be connected, {{firstName}}. I wrote to you about the phone side of access: patients feel the scheduling queue before anything else, and the experience surveys ask about it directly. Intradiem's new Queue Optimizer tracks each scheduling queue against its target and flags the move before one slips. It reaches beta this quarter. Open to a conversation on what a pilot on your scheduling queues would need?
Email 3 (day 11, breakup).
{{firstName}}, last note from me. If the phone side of access moves up the list when next year's plans get set, I'd be glad to pick this back up. Hope the scheduling lines hold steady through the fall.
Nathan
No cold sequence. Customers get this as content their account team carries: a one page piece per track with the chain above, the two days comparison from the Queue Optimizer deck, and the pilot as the next step. For Cleveland Clinic it lands in the marketing lane of the account plan Inger already runs, and the sponsor conversation stays with Amy and Inger.