2027 Star Ratings: What Health Plans Do Next
Barbara Swartos, Steady Solution Group
By the numbers
- 37% of MA-PD contracts earned 4+ stars, down from 44%
- 22% of MA contracts earned 4+ stars on diabetes medication adherence
- 74% of contracts below 5 stars on blood sugar are 1 to 3 points from the next star
- 4+ stars unlocks a 5% CMS quality bonus
- Medicare will pay at least $13.4B in quality bonuses in 2026 (KFF)
CMS released the 2027 Star Ratings on October 8, and for many health plans, the results weren't what they expected.
The numbers in the graphic tell the story. But the real question isn't what happened. It's what you do next. The 2026 measurement year closes December 31, and every HEDIS gap closed and on-time refill between now and then counts toward the 2028 Star Ratings.
I've spent decades understanding and building initiatives and programs to hit HEDIS and CMS Star Ratings cut points. The plans that move up don't wait for next October to find out. They know which measures are closest to the next star, they fix the data that's hiding care already delivered, and they make gap closure part of how provider offices work every day.
If your rating wasn't what you hoped for, contact us. Let's find your fastest gains before the year ends.