Medicare Advantage
About Half of the Performance Thresholds Used to Score Medicare Advantage Plans for 2027 Star Ratings Have Risen, Preliminary Data Shows
CMS shared a second round of preliminary 2027 star rating data with Medicare Advantage plans this month, and roughly half of the scoring thresholds are harder to meet than in prior years. Official star ratings are due in early October, just before open enrollment begins October 15.
By the Goodsurance editorial teamSeptember 12, 2026
CMS shared its second round of 2027 preview data with Medicare Advantage plans this month, and about half of the cut points, the numerical thresholds that translate performance scores into star ratings, are higher than before, according to an analysis of draft CMS technical notes by Healthcare Dive.
Of the measures reviewed, about 50 percent now have harder thresholds to clear, about 33 percent are unchanged, and about 17 percent are actually easier. Many of the tightening thresholds fall in the Healthcare Effectiveness Data and Information Set, known as HEDIS, where rising industry performance across plans has pushed benchmarks upward. Two examples from the draft data: the Kidney Health Evaluation for Patients with Diabetes measure rose by 7 to 10 percentage points depending on the star tier, and the Colorectal Cancer Screening measure tightened by 4 to 11 points.
About half of Medicare Advantage quality benchmarks for 2027 are now harder to meet. Official star ratings arrive in October.
Final 2027 star ratings for Medicare Advantage and Part D plans will be published in early October, ahead of the October 15 open enrollment start. Ratings run from 1 to 5 stars and summarize how well a plan performs on quality, safety, and member experience measures. Plans scoring below 4 stars for three consecutive contract years face additional federal oversight.
Star ratings also affect the quality bonus payments CMS makes to plans annually. Plans use those bonuses to help fund supplemental benefits such as dental, vision, and fitness programs. If ratings decline for 2027, some of those extras could be reduced or eliminated for the 2028 plan year.
In plain words
CMS shared early 2027 quality score data with Medicare Advantage insurance companies. About half of the goals plans must reach to earn high marks have gotten harder. Plans that earn high scores get extra money from the government that helps pay for things like dental and vision benefits. If scores drop, some of those extras may be cut in later years. Final scores come out in October, right before open enrollment starts.
Understand the basics first
Source: Healthcare Dive
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