Plan Preview 2: Why Higher Cut Points May Not Mean Higher Star Ratings in October

Plan Preview 2 is underway, giving us our first look at Medicare Advantage (MA) Star Year (SY) 2027 data. Until the final announcement in October, we will not know exactly how the Stars landscape will shake out. But we can begin to separate what we know from what we do not know, and identify a few important signals to watch.

Volatility in cut points, average values, and average ratings

There was significant volatility in cut points. You will see different assessments from analysts about what went up, what went down, and what stayed the same, depending on which measures are included. Looking across all returning measures, here is what the data shows:

• About 54% of cut points went up.
• About 36% stayed the same.
• About 10% went down.

Average measure values also saw notable changes:

• About 36% of average values went up.
• About 49% stayed the same
• About 15% went down.

Average ratings changed significantly as well:

• About 44% of average ratings went up.
• About 31% stayed the same
• About 26% went down.

How does this compare with SY 2026, and what could it tell us about October’s overall ratings?

As the chart below shows, we have seen volatility in cut points, values, and ratings in both years. Compared with SY 2026, the percentage of higher cut points was similar in SY 2027, while more stayed the same and fewer declined. Average values increased more often in SY 2026. Average rating increases were also similar across the two years, although more ratings stayed the same in SY 2027.

There is a lot to consider when interpreting these changes and what they could mean for SY 2027 overall ratings. In SY 2026, we saw more improvement than decline across all three categories, yet overall Star Ratings barely recovered. Because Stars is, in a sense, graded on a curve through clustering, with some guardrail factors, higher cut points, values, and ratings do not necessarily translate into higher overall ratings. A few factors may be influencing what we are seeing.

MA retrenchment is influencing cut points and averages

We are entering a new era that requires us to look differently at cut points and performance. Beginning in 2024, we started to see so-called MA retrenchment, with plans shedding lives, products, and geographies. That continued in 2025 and 2026 and will likely continue into 2027. Retrenchment was relatively light in 2024, when just 1% of enrollees were impacted by a plan closure. But the impact became much more significant in 2025, the measure year we are discussing, with about 6.9% of enrollees affected by plan and product closures. That surged to 10% in 2026. So far, at least 1 million enrollees will be impacted in 2027, compared with 2.6 million to 2.9 million in 2026.

So, what does this mean? While this will not be true in every case, plans generally closed products that were performing poorly, which would often include those with lower Star Ratings. As a result, some of the higher cut points and averages may reflect lower-performing plans exiting the market and pushing these factors upward. Because Stars is graded on a curve, however, that does not necessarily translate into higher overall ratings.

Plan investments may be paying off

There is reason to believe performance is improving in certain areas. While retrenchment affected some HEDIS measure cut points, roughly two-thirds to 70% of HEDIS cut points increased, with some reaching the maximum increase of 5. At least some of this may be tied to deeper penetration in risk or other value-based care (VBC) arrangements between payers and providers, where HEDIS measures are a key focus. We are also seeing evidence that plans are investing in supplemental and electronic data, as well as interoperability, in anticipation of ECDS electronic measure conversion. Year-round, AI-supported chart abstraction is also gaining traction.

On Part D drug measures, we saw some increases as well, although they were not demonstrable.

Despite significant interest in investments designed to move CAHPS and HOS survey performance, very little change was reported, including on the 3x-weighted Improving or Maintaining Physical Health and Improving or Maintaining Mental Health HOS measures.

Changes in Operational Measures were largely concentrated at the lower end of the cut points, suggesting retrenchment likely played a role. The Special Needs Plan Care Management measure increased across the board, which may signal investment in this growing product area.

So, should we expect a major uptick in overall ratings, or in the percentage of plans achieving 4 Stars, in October? Based on SY 2026 statistics and results, I would not count on it. The increases appear to be driven by retrenchment and, perhaps, some industrywide improvement in certain clinical measure areas. We may see some upward movement, but I do not expect anything particularly dramatic.

For Improvement clustering points, it became easier to achieve 2, 4, and 5 points (3 is always set to 0). This generally suggests that remaining plans have struggled somewhat to improve, even if Improvement ratings increase in some areas.

A closer look at a few measures

• Colorectal Cancer Screening (COL): I called this out last year, and it is worth revisiting. I still do not quite understand the rationale for deeming COL a non-substantive change when it moved to ECDS in MY 2024, but characterizing it as a substantive change with the addition of adults ages 45 to 50. It was “guardrailed” last year but not this year, which helps explain the cut point changes of 4 to 11. Some of the movement, however, could also reflect plans catching up to the ECDS conversion. This year, COL is not included in Improvement.

• Controlling Blood Pressure (CBP): Cut points changed by 4 or 5 points across the board, likely tied to some of the investments discussed above, as well as evolving approaches among plans related to chart chases, oversampling, and more.

• Kidney Health Evaluation (KED): This measure saw cut point moves of 9 to 12 points. Because it is only in year two, there are no guardrails. The significant increases across all cut points may reflect, in part, investments in a newer measure, although plan exits likely had some impact as well.

• Follow-Up ED Visit (FMC): This measure increased by 5 points at each cut point and is guardrailed. Investment here may be increasing given the surge of dual-eligible members with more chronic conditions entering the program.

• Care for Older Adults (COA): The COA measures also appear to be seeing investment, likely influenced by the influx of dual-eligible members and growth in Special Needs Plans (SNPs).

• Transitions of Care (TRC) and Plan All-Cause Readmissions (PCR): Lower-performing plans continue to struggle with TRC, while readmissions appear to be a challenge across plans.

What plans should take away from Plan Preview 2

Plan Preview 2 gives us plenty to watch, but the bigger story is not simply that cut points are moving up. Retrenchment, investments in clinical performance, changing measure dynamics and the continued shift toward electronic data are all influencing what we're seeing. Higher cut points and stronger average performance in certain areas are encouraging, but they do not automatically translate into higher overall Star Ratings. October will give us the complete picture.

For health plans, the takeaway is to look beyond the headline numbers. Understanding where performance is changing, what is driving those changes and where opportunities still exist will be increasingly important as the Stars landscape continues to evolve.