The 2027 Star Ratings Raised the Bar on the Measures Where Members Have to Act

At first glance, the 2027 Medicare Advantage and Part D Star Ratings barely moved, with the enrollment-weighted average for MA-PD contracts only slipping from 4.01 to 3.99. These ratings also determine 2028 Medicare Advantage quality bonus payments (CMS fact sheet). Fewer contracts cleared 4 stars (188, or 37%, down from 229), even as the share of members in those contracts rose to about 71% (CMS fact sheet). But the measures with the biggest drops are mostly ones a plan can’t manage on its own, because each depends on a member taking action, like refilling a prescription, completing a screening or lab test, or seeing a provider after an ED visit.

What This Means for Health Plans

• The biggest group sits just below the bonus threshold. The largest group of MA-PD contracts, 164 or about 32%, earned 3.5 stars, half a star below 4.0, which means the gains that matter for many plans are small and within reach (CMS fact sheet, Table 1).
• Put improvement efforts where members have to act. That’s where the biggest gaps are.
• Start with calendar year 2027. For most measures, the 2029 Star Ratings are built on 2027 performance, so the window for those gains opens in January.
• Know which books are structurally behind. Nonprofit MA-PD contracts reached 4+ stars at a higher rate than for-profit contracts (44% vs. 34%), and standalone PDP enrollment in 4+ contracts jumped from 2% to 22% in a single year on a volatile, 41-contract universe.

An annually rising bar makes the work needed to get members to take action a year-round proposition, which favors plans that treat improvement as ongoing. The plans best positioned to hold or gain ground are the ones that start two-way text conversations that turn into refilled prescriptions, completed follow-ups, and closed care gaps.

Diabetes Adherence Is a Warning Sign

Average stars for Medication Adherence related to Diabetes Medications have fallen four years in a row among MA-PD contracts: 3.3 in 2024, 3.2 in 2025, 3.1 in 2026, and 2.7 in 2027. The decline matters because adherence measures carry triple weight in the overall rating. Diabetes adherence is also among the hardest measures to move from inside a care team, since it comes down to whether a member refills on time between visits, month after month. For plans, that makes diabetes adherence the most urgent year-round target, since it’s moving the wrong way four years straight. The other two adherence measures held steady, with hypertension moving from 3.3 to 3.4 and cholesterol from 3.2 to 3.3.

What the Biggest Drops Have in Common

Each one depends on a member completing a specific action.

*Stars and thresholds from the CMS fact sheet (Tables 7-8) and the 2027 Part C and D cut points. CMS respecified Colorectal Cancer Screening for 2027, so part of its change reflects methodology.

The other three were Medicare Plan Finder price accuracy, monitoring physical activity, and drug plan quality improvement. Separately, patient experience measures held mostly flat, moving 0.2 stars or less, while two member-influenced measures moved the other way, with readmissions rising from 2.9 to 3.4 and transitions of care from 3.1 to 3.4.

The Bar Rose

CMS recalculates cut points every year based on how plans performed during the measurement period, so a threshold that climbs signals the field moved up with it. On kidney health evaluation, the score needed for 4 stars jumped 10 points in a single year, from 62% to 72%. It rose 5 points on ED follow-up and 4 on blood pressure control.

For a plan, maintaining last year’s results is no longer enough to hold last year’s stars. Improvement must keep pace with a field that is also improving, and on these measures each point of improvement means more members completing an action they hadn’t before.

The Measure Set Keeps Shifting

This year, CMS also changed the measure set itself, not just the cut points behind it.

• Improving or Maintaining Physical Health and Improving or Maintaining Mental Health went from a weight of one to a weight of three, so they now carry more influence over the overall rating even if their scores didn’t move.
• Two Part D measures were added (Concurrent Opioid and Benzodiazepine Use, and Anticholinergic Polypharmacy), and Functional Status Assessment returned after specification changes. Both are new enough that no prior-year cut point or playbook exists yet, an open window for plans that start early.
• Pain Assessment and Medication Reconciliation Post-Discharge were retired.

More is coming. The CY 2027 final rule retires 11 measures by the 2029 Star Ratings (13 counting Part C and Part D versions separately), mostly operational and patient experience measures like appeals, complaints, and customer service. Depression Screening and MTM Completion Rate join in 2029, based on 2027 performance. Fewer measures means each clinical and pharmacy measure left carries more weight.

The Bottom Line

None of the 2027 star ratings change the math: holding or raising a rating still comes down to getting more members to take the next step.

For the health plans we work with, Drips is a managed program built for that kind of continuous improvement. A Drips team keeps refining every conversation so more members follow through, using the Drips Connect platform to turn disconnected outreach into connected conversations that guide members to action—all inside a compliance engine of more than 1,000 rules drawn from HIPAA, TCPA, FCC, CMS, and state regulations.

The plans that build that muscle now are the ones that will still be clearing the bar when CMS raises it again next year.

Sources

CMS: 2027 Medicare Advantage and Part D Star Ratings fact sheet

CMS: Part C and D Star Ratings Technical Notes and Data

Federal Register: CY2027 Medicare Advantage and Part D Final Rule

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