Feels Different: How MedOrion’s Platform Approaches Mental Health Measures

May is Mental Health Awareness Month, making it the right time to examine how mental well-being is reflected in CMS Star Ratings, how health plans can improve their performance on these specific measures, and how MedOrion’s platform helps them better understand and respond to the people behind the scores.

What the HOS Tells Us About Member Well-Being

The first thing to remember is that the Health Outcomes Survey (HOS) is different from other performance tools in that it does not focus on service delivery or medication tracking. Instead, it asks a random sample of members how they feel and how their health affects their ability to live their lives, and repeats the process two years later. Evaluation of scores is based on changes over time.

In other words, this clinical improvement tool relies heavily on perception. Plans are measured on how supported members feel, how aware they are of available resources, and whether they believe they are managing their mental health better than before. Research shows a correlation between people’s belief that they can promote their mental health and actual well-being improvements, meaning that perception and objective results often go hand in hand. 

The Real-Life Struggles Behind Survey Scores

Before we discuss a few common situations, it’s important to understand that the platform does not focus on one or two metrics or survey items. It combines a long list of considerations to form a data-based member profile. The following scenarios present some prominent parts of the puzzle, while the big picture is far more elaborate and complex. 

Managing illness in isolation
The connection between loneliness and depression, for instance, is long known. Some members face serious health conditions like heart failure, diabetes, or cancer while living alone and far from friends or family. They may stick to their treatments, attend appointments, and follow instructions, but the physical toll is amplified by the lack of social support. The emotional cost of managing it all alone is often reflected in their HOS survey responses.

Low socioeconomic status and strong adherence 
For members with fewer resources who are fully adherent to care plans, every action takes a toll. Transportation is difficult. Time off work is unpaid. Medications stretch the household budget. These members are often focused on the effort it takes to stay “on track,” which leaves them exhausted and their mental health overlooked. 

Low confidence in communication
Other members struggle to connect with their providers. Language barriers or a lack of trust make it hard to ask questions or feel heard. These communication gaps often show up in questions about emotional well-being or interference with everyday life. It is also likely that these are immigrants suffering the difficulties associated with their current status, which also impacts their mental well-being.

Mismatch between education and resources
Some members with higher education and professional experience find themselves in unexpected situations. A severe illness or traumatic event can derail a career and create financial strain. For people who once had stable incomes and full autonomy, the loss of control can lead to a sharp decline in mental well-being. 

How MedOrion Helps Improve Mental Health Scores

We do not aim to improve mental health outcomes directly. Our role is to help health plans improve HOS scores by better understanding members’ lived experiences and delivering the right message at the right time.

First and foremost: empathy. Studies show that a lack of empathy negatively impacts people’s physical and emotional well-being. Members who struggle with physical and mental challenges need health plans to approach them with attentive, caring messages and tone. 

And there’s a lot more for health plans to offer. Once at-risk individuals are identified through behavioral modeling, we tailor outreach that acknowledges their situation, offers validation, and points to available resources. Examples include:

• Letting isolated members know that community support programs or telehealth options are available.
• Reaching out to overburdened members with gentle reminders that their emotional well-being matters too.
• Encouraging members with communication difficulties to prepare for provider visits.
• Providing tools that help members maintain a sense of control and activity.
• Opting for a proactive, preventive approach that doesn’t wait for members to notice they need support, encouraging them to pay attention and address challenges early on by reminding them that they deserve to feel seen and cared for.

Messages are designed to be empathetic and realistic. The goal is to boost the member’s sense of support and agency.

From Recognition to Results

Using behaviorally driven insights, MedOrion gives health plans a practical way to influence how members perceive their health. Improving HOS mental health scores is about connecting existing support to the right people, in the right tone, at the right time.

When members feel their challenges are understood and support is within reach, they are more likely to report a better experience. That shift improves scores and builds stronger, healthier relationships with members.