The 2027 Medicare Advantage (MA) Star Ratings results are in, and health plans continue to face challenges maintaining and improving quality performance.While some plans made meaningful gains, many experienced declining ratings. Overall industry performance remained relatively flat, continuing a trend that has persisted since Star Ratings peaked in 2022.
For Medicare Advantage organizations, these results highlight the importance of understanding where performance is declining, which measures are driving results, and how upcoming changes to the Star Ratings program could affect future performance and revenue.
The 2027 results reveal a mixed picture. Some plans improved, but a larger number experienced declining ratings.
Three findings stand out:
The comparisons use the recalculated SY 2026 ratings announced in July 2026.
The results also show considerable movement between rating categories. Among the 468 contracts rated in both years, 88 improved, 183 declined, and 197 remained unchanged.
Although enrollment in higher-rated contracts increased, the overall decline in the number of contracts achieving 4 Stars suggests that maintaining strong quality performance remains difficult across the industry.
A closer look at individual measures helps explain why plans continue to struggle.
Of the Part C measures compared between 2026 and 2027, 14 experienced declining average Star Ratings, while eight improved and nine remained unchanged.
However, declining Star Ratings don't always mean clinical performance is getting worse. In several cases, average measure performance improved while the corresponding Star Rating declined.
For example:
These results illustrate why understanding cut points is so important. Even when health plans improve their clinical performance, changes in rating thresholds can affect how those improvements translate into Stars.
Part D measures also experienced mixed results, with declining average ratings for measures including Medication Adherence for Diabetes Medications and Statin Use in Persons with Diabetes.
For health plans, the takeaway is clear. Improving quality performance remains essential, but teams also need to understand how their results compare with changing cut points and how individual measures contribute to their overall contract rating.
The 2027 results are especially important when considered alongside the upcoming changes to the Medicare Advantage Star Ratings program.
Beginning with Star Year 2029, CMS is restructuring the program by removing several operational measures and placing greater emphasis on clinical outcomes and member experience.
Under the revised structure, the number of measures will decrease from 45 in SY 2027 to 34 in SY 2029.
Clinical outcomes, including HEDIS and medication-related measures, will account for approximately half of the available rating points. Survey measures, including CAHPS and the Health Outcomes Survey (HOS), will represent approximately one-third.
This matters because clinical and survey measures are already among the areas where many plans are struggling.
CMS estimates that the restructuring could result in approximately 25% of contracts losing half a Star, while 13% could gain half a Star. Other industry analyses suggest the negative impact could be greater.
For plans currently performing near a rating threshold, even modest changes in measure performance or weighting could have significant financial implications.
The 2027 results reinforce the need for a more proactive approach to managing Star Ratings performance.
Health plans should focus on several areas as they evaluate their results and prepare for future measurement years.
Understand contract-level exposure. Evaluate how the upcoming measure changes could affect each contract's overall rating, particularly those performing near the 4-Star threshold.
Monitor cut points and measure performance. Review historical and projected cut points to identify measures where improvement could have the greatest impact on overall ratings.
Prioritize clinical outcomes and member experience. With greater weighting on HEDIS, medication adherence, CAHPS, and HOS measures beginning in 2029, plans should evaluate whether current improvement strategies are focused on the measures that will matter most.
Improve access to timely performance data. Waiting until the end of a measurement year limits opportunities to address care gaps. More frequent performance monitoring can help teams identify declining trends and adjust improvement efforts while there is still time to influence results.
Connect quality improvement to financial planning. Understanding how measure-level performance affects overall Star Ratings and potential revenue can help plans make more informed decisions about where to invest their resources.
The 2027 Medicare Advantage Star Ratings results show that maintaining strong performance remains challenging, even for established health plans.
With additional changes approaching in 2029, plans should evaluate how their current performance strategies align with the measures that will carry greater weight in future ratings.
The most useful starting point is a clear understanding of performance at both the contract and measure level. By identifying which measures are driving results, evaluating proximity to cut points, and monitoring progress throughout the year, health plans can make better-informed decisions about where to focus their quality improvement efforts.
The goal is to give quality teams the information they need to address performance gaps earlier and improve results over time.
Want the full analysis? Read Marc's original article on Healthcare Labyrinth.