Medicare Advantage Star Ratings
Expert articles and analysis related to medicare advantage star ratings.
AI Summary â Last 30 Days
CMSâs 2027 Medicare Advantage Star Ratings release is reshaping 2028 revenue expectations: more than 70% of MA-PD beneficiaries are now in contracts rated 4+ stars, positioning plans for quality bonus payments and higher rebates, but rising cut points and lower reward-factor thresholds signal tighter economics and greater operational pressure on quality, CAHPS, medication adherence, and Stars governance. At the same time, litigation and enforcement are intensifyingâCentene is pursuing roughly $448 million tied to Star Ratings rules, while OIG/DOJ activity around MA diagnosis coding and False Claims Act risk reinforces that MA value-based revenue is increasingly exposed to both quality-measure methodology disputes and risk-adjustment compliance scrutiny. For ACOs, risk-bearing providers, and payer partners, the strategic takeaway is that MA contracting value will depend less on broad Stars participation and more on defensible coding, measure-level performance management, and contract terms that allocate bonus upside and audit/litigation downside explicitly (HFMA on 2027 Star Ratings; Wakely on cut points and 2028 revenue).
Related Articles
2027 Medicare Advantage Star Ratings: Stability at the Surface, Volatility Underneath
Download Wakelyâs analysis of the 2027 Medicare Advantage and Part D Star Ratings Wakelyâs analysis of the 2027 Star Ratings data tells a different story from what published commentary by the Centers ...
Medicare Advantage star ratings trigger stock jumps, lawsuit
Medicare Advantage star ratings are in!
Nearly Three-Quarters of Medicare Advantage Enrollees Could be Denied a Medigap Policy Due to a Pre-Existing Condition
This analysis examines the share of Medicare Advantage enrollees who have a pre-existing condition that could result in a Medigap denial if they seek to switch to traditional Medicare outside their on...
Traditional Medicare and Medicare Advantage: Understanding the differences
Traditional Medicare and Medicare Advantage: Understanding the differences  Aledade
2027 Medicare Advantage Star Ratings show gains in high-rated plan enrollment
More than 70% of beneficiaries in Medicare Advantage (MA) plans that include prescription drug coverage are in contracts rated at least four stars out of five, according to CMSâs Star Rating release f...
Humana soars, Alignment plummets in 2027 Medicare Advantage star ratings
A Healthcare Dive analysis of highly anticipated stars data for next year shows a potpourri of winners and losers, though â as expected â the quality scores slipped overall. See how major carriers far...
Medicare 101
This Health Policy 101 chapter explores Medicare, a federal health insurance program covering more than 68 million people, established in 1965 for people age 65 or older and later expanded to cover pe...
2027 Medicare Advantage Second Plan Preview: Why Higher Cut Points Could Still Mean Lower 2028 Revenue
New analysis of the 2027 Medicare Advantage Star Ratings Draft Technical Notes released with the Second Plan Preview shows a challenging outlook for health plans. Although more measure-level cut point...
CMS issues proposals to improve MA plan provider directory accuracy, PBM transparency requirements and reduce drug costs
CMS issues proposals to improve MA plan provider directory accuracy, PBM transparency requirements and reduce drug costs  American Hospital Association
71% Of Medicare Advantage Prescription Drug Plan Enrollees In Four- Or Five-Star Plans For 2027 - open minds
71% Of Medicare Advantage Prescription Drug Plan Enrollees In Four- Or Five-Star Plans For 2027Â Â open minds