The Centers for Medicare & Medicaid Services (CMS) released the 2027 Medicare Advantage (MA) and Part D Star Ratings on October 8, 2026. CMS reported little change in the number of contracts earning at least 4 Stars and an increase in enrollment in higher-performing plans. Wakely Consulting Group, an HMA Company, found more year-over-year change than those figures suggest.
Wakely’s new white paper, Stars Gone Wild: Summary of 2027 Medicare Advantage and Part D Star Ratings, examines how plan performance changed and what the 2027 results mean for Medicare Advantage (MA) organizations’ quality strategies and future quality bonus payments (QBPs).
2027 Star Ratings: Rising Cut Points and Quality Bonus Payments
Achieving 4 Stars has a direct financial implications for Medicare Advantage plans. Contracts rated at 4 Stars and higher receive a 5% increase in benchmark rates through the QBP. Even a small ratings change that moves a contract above or below that threshold can significantly affect payment. The 2027 Overall Star Ratings will determine QBPs for the 2028 payment year.
Wakely found that plan performance in general improved between the measurement years underlying the 2026 and 2027 Star Ratings, but Star Rating cut points rose slightly faster. After adjusting for enrollment changes, crosswalks, and plan terminations, the enrollment-weighted average Overall Star Rating fell from 4.08 in 2026 to 4.01 in 2027. The share of enrollment in contracts rated at least 4 Stars also fell from 73.2% to 71.7%.
CMS and Wakely present different perspectives on enrollment trends. CMS’s figures reflect enrollment at the time each year’s Star Ratings are published. Wakely’s year-over-year analysis uses updated enrollment information for both years and accounts for known plan crosswalks and terminations. Under Wakely’s approach, the 2026 baseline for enrollment in 4+ Star plans is approximately 73% versus approximately 67% in CMS’s published figures. Using that baseline, Wakely’s analysis shows a decline in 2027.
The 2026 Star Ratings determine QBPs for the 2027 payment year. Using current enrollment information helps plans estimate how many members will be affected by the associated rate adjustments and how those changes will influence QBP revenue.
Medicare Advantage Star Ratings Results by Insurer
National averages mask large differences among insurers.
Wakely examined the 10 largest parent organizations, which account for 27.8 million members (~ 80%) of MA-PD enrollment. Humana’s share of enrollment in 4+ Star contracts increased by 53% in 2026–2027. Much of that increase came from a single contract, which covers more than 2 million members and improved from 3.5 to 4 Stars. Kaiser maintained 100 percent of its membership in 4+ Star plans for the third consecutive year.
Health Care Service Corporation’s enrollment in 4+ Star contracts declined by 47.6%. United and CVS each saw approximately 15% of their membership drop below the 4-Star threshold, representing roughly 2 million members combined.
Special Needs Plans: Enrollment in 4+ Star Contracts Declines
Wakely’s analysis of Special Needs Plans (SNPs) analysis covers more than 10.7 million members. The share of enrollment in 4+ Star SNP contracts fell from 78% in the 2026 Star Ratings to 55% in 2027, a 23% decline. Of the five largest SNP parent organizations, only Humana saw an increase. United, which has more than 3.7 million SNP enrollees, experienced a 27% decline in 4+ Star SNP contract enrollment.
MA Star Ratings Trends by State
Some states saw steep declines in enrollment among plans with higher ratings, whereas others saw large gains. Rhode Island, Louisiana, and Georgia had the largest declines in enrollment in 4+ Star contracts, while Montana, South Dakota, and North Dakota had the greatest increases. Among the states highlighted in Wakely’s paper, Rhode Island experienced the steepest decline, from 94.6% to 35.0%. South Dakota rose from 37.8% to 100%. These state-level differences show why national trends alone may tell plans little about what is changing in their own markets.
Quality Improvement Strategies for Medicare Advantage Star Ratings
Star Ratings connect the care members receive with the bonus funding plans can use to support benefits and other priorities. That makes it important to know whether investments in provider engagement and member outreach are closing gaps in care, improving outcomes, and helping plans perform better on the measures that drive their ratings.
Health Management Associates (HMA) work on quality improvement and Wakely’s Star Ratings analysis reinforce the connection between care outcomes and financial decisions. Clinical, quality, member engagement, and provider strategy teams have developed an understanding of what members need; actuarial, data, and financial consultants help assess the results and financial implications. Together, they can use those findings to guide spending, set clear responsibility for improvement, and focus resources as rating standards and regulations change.
Star Ratings Litigation and Potential Methodology Changes
CMS recalculated ratings across the market following litigation over the 2026 ratings, including Clover Health’s challenge, but used the previously finalized measure set for 2027. Wakely estimates that measures representing approximately two-thirds of the program’s current weight remain subject to legal uncertainty.
Wakely anticipates significant program changes, leaving plans to meet current requirements while preparing for shifts in measures and methodology, including those that could result from litigation.
Medicare Advantage Star Ratings Support from HMA and Wakely
Understanding what drives a plan’s Star Ratings is only part of the work. HMA and Wakely bring together actuarial analysis, risk adjustment, rate setting, quality strategy, payment policy, and competitive positioning to help plans turn those findings into an improvement strategy.
Our integrated teams connect the clinical and operational work of improving quality with the financial and market decisions plans face. We support plans in their efforts to analyze performance and forecast payment impacts, set priorities, implement quality strategies, and track progress as rating standards change.
For a closer look at the findings, read Wakely’s Stars Gone Wild: Summary of 2027 Medicare Advantage and Part D Star Ratings and join the November 5, 2026, Stars Gone Wild webinar for a discussion of the results and the policy and methodology changes ahead.
Contact HMA and Wakely to discuss the factors that are driving your plan’s Star Ratings and how our teams can help improve performance, prepare for payment changes, and strengthen your competitive position.
