Cut through the noise, find the signal: Intelligence for serious healthcare leaders
How CMS grades MA plans, what each measure is worth, and where the money moves.
From 2013–2025, CAHPS and Access measures had the second-highest weight (4), making patient satisfaction a dominant driver of overall ratings. The 2026 reduction to weight 2 cuts their relative influence in half, making clinical outcomes and improvement the primary determinants of Star Ratings.
Click a category name to see its definition and strategic context.
| Category | 2007–2012 | 2013–2025 | 2026 | 2027+ |
|---|---|---|---|---|
| N/A then 5 | 5 | 5 | 5 | |
| 1 then 3 | 3 | 3 | 3 | |
| 1 then 1.5 | 4 | 2 | 2 | |
| 1 then 1.5 | 4 | 2 | 2 | |
| 1 | 1 | 1 | 1 | |
| 1 | 1 | 1 | 1 |
Sum of (measure weight × count) per category — the total rating influence each category carries, counting both how many measures it has and their weights.
| Category | 2016 | 2019 | 2022 | 2024 | 2026 | 2027 |
|---|---|---|---|---|---|---|
| Process | 21.5 | 20.5 | 20 | 18 | 19 | 21 |
| Outcome | 22 | 22 | 16 | 14 | 20 | 24 |
| CAHPS | 48 | 48 | 48 | 48 | 24 | 24 |
| Access | 14 | 16 | 16 | 16 | 8 | 8 |
| Improvement | 10 | 10 | 10 | 10 | 10 | 10 |
Values = sum of measure weights in each category. Example: 3 outcome measures at weight 3 = 9 weighted points. New measures (*) count at their introductory weight.
Plans rated 4+ stars receive a 5% benchmark increase (10% in double-bonus urban counties). QBP demo 2012-2014 extended to 3+ stars. Estimated $15 billion in total QBPs by 2026. A single half-star change for a large MA organization can mean hundreds of millions in revenue.
CMS source documentation