Quality Metrics & Ratings

CMS’s 2027 Medicare Advantage Star Ratings are reshaping VBC economics: more than 70% of MA-PD beneficiaries are now in contracts rated 4+ stars, positioning those plans for quality-bonus payments and higher 2028 rebates, while carrier performance diverged sharply with Humana rebounding and Alignment, Aetna, UnitedHealth, and HCSC facing pressure from slipping scores (HFMA, Healthcare Dive). For payers and provider groups in MA risk arrangements, the week’s ratings reinforce that quality operations, documentation, member experience, and measure-specific execution remain direct revenue levers—especially as bonus uncertainty and contract-level volatility create winners and losers in bids, rebates, and supplemental-benefit capacity. Medicaid quality strategy also remained in focus, with Medicaid ACOs positioned as vehicles to improve maternal health outcomes, underscoring a broader shift toward tying population-health priorities to accountable payment models.