Stability and Predictability Matter for the Future of Medicare Advantage Star Ratings
For more than a decade, the Star Ratings program has served a dual purpose for Medicare Advantage. It helps seniors make informed coverage decisions while encouraging health plans to invest in better outcomes, stronger patient experiences, and higher-quality care. The program has been a key driver of quality improvement, rewarding plans and providers that deliver better care for beneficiaries. The results speak for themselves: For example, between the 2012 and 2026 Star Ratings, medication adherence for cholesterol and controlling blood pressure improved by 20% and 18%, respectively, among MA beneficiaries.
As CMS continues its efforts to modernize and strengthen Medicare Advantage, greater stability and predictability should be guiding principles for the future of the Star Ratings program. Beneficiaries, plans, providers, and CMS all benefit when program rules are clear, transparent, and established well in advance.
Over the past several years, Medicare Advantage beneficiaries have already absorbed plan closures and benefit reductions. An unstable Star Ratings program would only compound those disruptions. The final 2027 Star Ratings, which will directly affect 2028 payments, are scheduled for release this October, yet questions remain about what the underlying methodology will be — and what benefits and plan options will be available to seniors as a result.
The work behind these ratings starts years in advance. Health plans and providers develop quality improvement initiatives, value-based care incentives, preventive care programs, and chronic disease management strategies based on their current understanding of the Star Ratings program. But without clarity, or when federal rules change unexpectedly, it becomes difficult for plans to make these important investments — and beneficiaries often pay the price.
Meaningful investment in quality requires a stable regulatory environment and confidence that performance will be evaluated using clearly defined and consistently applied standards. The need for that certainty is especially pressing as policymakers consider the future of Star Ratings and the questions raised by ongoing litigation, including the Clover Health ruling.
In future rulemaking, including the 2028 Rate Notice, policies that promote consistency, transparency, and predictability will help preserve the integrity of the Star Ratings program, support long-term investments in quality improvement, and ensure beneficiaries continue to have access to reliable information when choosing their Medicare coverage.
Better Medicare Alliance supports a hold harmless approach to address unresolved methodological issues within the Star Ratings program and limit litigation. Plans should not be penalized for changes driven by measurement or methodological uncertainty rather than actual performance, and seniors should not see their benefits or plan options change as a result.
This moment represents an important opportunity to strengthen the Medicare Advantage program while preserving the qualities that have made it successful. We welcome engagement with policymakers to advance a stable, predictable, and sustainable quality measurement framework — one that provides meaningful information to beneficiaries, promotes continuous quality improvement, and ensures fair and consistent evaluation across Medicare Advantage plans.