Medicare Advantage (MA) Star Ratings

On April 2, 2026, the Centers for Medicare & Medicaid Services (CMS) issued a final rule revising the Medicare Advantage (MA) Program, Medicare Prescription Drug Benefit Program (Part D), and Medicare Cost Plan Program. The Contract Year (CY) 2027 MA and Part D final rule aims to improve quality and access to care for people enrolled in these programs by finalizing updates to MA and Part D Star Ratings quality measurements and streamlining certain enrollment processes. 

  • The Star Ratings system helps Medicare beneficiaries compare health and drug plan quality. Star Ratings also determine Quality Bonus Payments and impact rebates for MA contracts, currently rating MA-PD contracts on up to 43 measures, MA-only contracts on up to 33 measures, and Part D plans on up to 12 measures across five categories: outcomes, intermediate outcomes, process, patient experience, and access. 

  • CMS is finalizing two sets of major changes to the Part C and Part D Star Ratings system. First, for the 2027 Star Ratings, CMS is not implementing the Excellent Health Outcomes for All reward (previously called the Health Equity Index reward) that was developed to incentivize improved performance for a subset of enrollees and will continue the historical reward factor that encourages consistently high performance for all enrollees across all quality measures. Second, CMS is streamlining and refocusing the measure set by removing 11 measures focused on administrative processes and areas where beneficiaries cannot distinguish performance between plans due to high performance and little variation. Additionally, CMS is adding a new Part C Depression Screening and Follow-Up measure to address behavioral health gaps starting with the 2027 measurement year and 2029 Star Ratings. CMS is also finalizing a technical clarification from the CY 2026 MA and Part D proposed rule related to contract consolidations.

    • Plan Makes Timely Decisions about Appeals (Part C – 2029 Star Ratings)

    • Reviewing Appeals Decisions (Part C – 2029 Star Ratings)

    • Special Needs Plan (SNP) Care Management (Part C – 2029 Star Ratings)

    • Call Center – Foreign Language Interpreter and TTY Availability (Part C – 2028 Star Ratings)

    • Call Center – Foreign Language Interpreter and TTY Availability (Part D – 2028 Star Ratings)

    • Complaints about the Health/Drug Plan (Parts C and D – 2029 Star Ratings)

    • Medicare Plan Finder Price Accuracy (Part D – 2029 Star Ratings)

    • Diabetes Care – Eye Exam (Part C – 2029 Star Ratings)

    • Statin Therapy for Patients with Cardiovascular Disease (Part C – 2028 Star Ratings)

    • Members Choosing to Leave the Plan (Parts C and D – 2029 Star Ratings)

    • Customer Service (Part C – 2029 Star Ratings)

    • Rating of Health Care Quality (Part C – 2029 Star Ratings)

  • CMS actuarial estimates project that these changes—specifically the retention of the historical reward factor and measure set refinements—will increase Medicare spending by approximately $13.8 billion between 2027 and 2036. This increase is largely driven by higher Quality Bonus Payments (QBPs) resulting from the revised ratings methodology.