Creator: Patrick Connole
CMS Releases MA and Part D Star Ratings
CMS has released the 2027 MA and Part D Star Ratings.
The Centers for Medicare and Medicaid Services (CMS) on Oct. 8 released the Medicare Advantage (MA) and Medicare Part D Star Ratings, with changes made for the 2027 plan year.
All of the tables that accompany the text below are available here.
CMS publishes the MA (Medicare Part C) and Part D Star Ratings each year to measure the quality of health and prescription drug services received by consumers enrolled in MA and Part D prescription drug plans (PDPs or Part D plans), the agency said.
“An important component of the Star Ratings is to provide people with Medicare and their caregivers with meaningful information about the quality of plans in Medicare Plan Finder, alongside information about benefits and costs, to assist them in comparing Medicare health and drug plans and choosing the Medicare coverage option that best fits their health needs,” CMS said.
The 2027 Star Ratings announced today appear on Medicare Plan Finder for 2027 Open Enrollment, which begins on Oct. 15 and runs through Dec. 7, and will impact 2028 MA quality bonus payments.
Highlights of Contract Performance in 2027 Star Ratings
MA Prescription Drug (MA-PD) contracts are rated on up to 43 unique quality and performance measures; MA-only contracts (without Part D coverage) are rated on up to 32 measures; and standalone PDP contracts are rated on up to 13 measures. For each measure, CMS establishes thresholds called “cut points” that are used to determine whether each contract’s performance for that measure receives a one, two, three, four, or five-star rating, CMS said.
Changes in the Methodology for the 2027 Star Ratings
The agency said it made changes to the methodology for the 2027 Star Ratings through previous notice and comment rulemaking. There are two new measures added beginning with the 2027 Star Ratings: Concurrent Use of Opioids and Benzodiazepines (COB) and Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH).i The Care for Older Adults — Functional Status Assessment measure is returning to the 2027 Star Ratings after substantive specification changes.
The respecified Colorectal Cancer Screening measure was moved into the 2027 Star Ratings as a new measure, replacing the legacy Colorectal Cancer Screening measure.
All of these measures are process measures developed from evidence-based clinical treatment guidelines, each with a weight of one, CMS said.
These clinical process measures are critical for measuring healthcare and medication use quality, ensuring that care is delivered effectively, and preventing long-term health consequences by addressing potential health concerns early in the beneficiary’s care.
The weight of the Improving or Maintaining Physical Health and Improving or Maintaining Mental Health measures increased from a weight of one for the 2026 Star Ratings to a weight of three beginning with the 2027 Star Ratings following a substantive measure specification change.
The Medication Therapy Management (MTM) Program Completion Rate for Comprehensive Medication Review (Part D) measure was transitioned to the display page for measurement years 2025 and 2026 and will return to the Star Ratings as a new measure beginning with the 2029 Star Ratings (measurement year 2027). Additionally, the Care for Older Adults — Pain Assessment (Part C)ii and Medication Reconciliation Post-Discharge (Part C)i measures were retired from the Star Ratings.
For the 2027 Star Ratings, CMS began using data collected through the Part C Reporting Requirements (as described at § 422.516(a)) to confirm the completeness of the Independent Review Entity (IRE) data used in the calculation of the Plan Makes Timely Decisions about Appeals and Reviewing Appeals Decisions measures. As codified at § 422.164(g)(1)(iii), CMS used these data to implement scaled reductions data integrity issues were identified.
Rating Distributioniii
The last row in Table 1 (in the link above) shows the trend in the average overall Star Ratings weighted by enrollment for MA-PDs from 2024-2027 after any adjustments for extreme and uncontrollable circumstances.iv
Approximately 37 percent of MA-PDs (188 contracts) that will be offered in 2027 earned four stars or higher for their 2027 overall rating.
Weighted by enrollment, approximately 71 percent of MA-PD enrollees are currently in contracts that will have four or more stars in 2027.
Changes in Star Ratings year-over-year are normal and expected and vary by measure, the agency said. Star Ratings are intended to capture a contract’s performance during the measurement period, with some contracts performing better or worse in different years. The cut points are recalculated each year based on performance during the measurement period. The 2026 overall rating data reflect the updates for MA contracts that had their 2027 Quality Bonus Payment rating updated in June 2026 and their 2026 overall rating updated in Medicare Plan Finder in July 2026, CMS said.
Five-Star Contracts
CMS said a total of 15 MA-PD contracts are highlighted on the Medicare Plan Finder with a high-performing iconv indicating they earned five stars (Table A1 in Appendix). For 2027, six of the contracts receiving the high-performing icon also received it in 2026.
Consistently Low Performers
There are four MA-PD contracts identified on the Medicare Plan Finder with a low-performing icon (LPI)vi for 2027 for consistently low-quality ratings. Last year, four contracts received this icon.
Tax Status and Performance
CMS said nonprofit organizations more frequently earn higher ratings than organizations that are for-profit. For MA-PDs, approximately 44 percent of nonprofit contracts received four or more stars compared to 34 percent of for-profit MA-PDs. For PDPs, approximately 28 percent of nonprofit PDPs received four or more stars compared to 27 percent of for-profit PDPs.
Length of Time in Program and Performance
Generally, higher overall Star Ratings are associated with contracts that have more experience in the MA program, CMS said.
MA-PDs with 10 or more years in the program are more likely to have four or more stars compared to MA-PDs with less experience in the program. There are very few PDPs with less than 10 years of experience in the program so the relationship is not as clear. There are only five PDPs with less than 10 years of experience, and they all earned 3.5 or fewer stars.
Comments or questions? Contact Patrick Connole at pconnole@parkplacelive.com.
