09/14/2026
More changes are coming to Medicare Advantage in 2027 — and this one is worth watching.
CMS has released its draft Star Rating cutpoints for 2027, and according to this recent Healthcare Dive article, roughly 50% of the thresholds are getting tougher to reach, while 33% remain unchanged and only 17% are getting easier.
Why does this matter?
Star Ratings can have a significant impact on Medicare Advantage plans — including the bonus payments they receive and their ability to offer competitive benefits. Even a half-star change can have a substantial financial impact on a plan.
What caught my attention is that many of the tougher thresholds are tied to HEDIS measures involving things like preventive care, screenings and health outcomes. In other words, plans are going to have to continue finding ways to improve how they engage with and care for their members.
And with 2027 Medicare plan information just around the corner, this is another reminder that Medicare Advantage is anything but “set it and forget it.”
For beneficiaries, it will be important to look beyond just the premium or extra benefits when comparing plans. Network, prescription coverage, provider access, plan changes, and overall plan quality all deserve a closer look.
As brokers, staying on top of these changes is a big part of helping our clients make informed decisions during the Annual Enrollment Period.
Interesting times ahead in the Medicare Advantage market.
Worth the read:
“Half of Medicare Advantage stars thresholds harder to reach in 2027”
https://www.healthcaredive.com/news/medicare-advantage-stars-cutpoints-2027-cms/829963/
The CMS released draft star ratings, including the thresholds for reaching those ratings, to plans earlier this week. The grading sheet got stricter, which doesn’t bode well for insurers, one MA expert said.