Download Wakely’s analysis of the 2027 Medicare Advantage and Part D Star Ratings
Wakely’s analysis of the 2027 Star Ratings data tells a different story from what published commentary by the Centers for Medicare & Medicaid (CMS) suggests. While CMS reports stable enrollment in bonus-eligible plans, our analysis using consistent, normalized enrollment figures shows meaningful market deterioration masked by strong performance from a few major organizations.
Using normalized enrollment data adjusted for plan crosswalks and terminations, overall Star Ratings declined from 4.08 in 2026 to 4.01 in 2027, and enrollment-weighted 4+ Star enrollment fell from 73.2% to 71.7%. The decline is masked by significant gains at Humana and Kaiser, which concentrated improvements among a few major contracts. At the same time, ongoing litigation is creating increasing uncertainty around the future of the Star Ratings program and the revenue bonuses tied to quality performance.
Download Wakely’s white paper, Stars Gone Wild: Summary of 2027 Medicare Advantage and Part D Star Ratings, for an analysis of the trends shaping the 2027 rating year and the strategic implications for Medicare Advantage organizations.
DOWNLOAD NOWWhat This White Paper Covers
Wakely’s analysis examines:
- Overall changes in Medicare Advantage Star Ratings and QBP-eligible enrollment
- Star Rating changes among the 10 largest parent organizations
- The impact of 2027 ratings on Special Needs Plan enrollment
- States with the largest increases and decreases in enrollment in 4.0-Star-or-higher contracts
- The implications of ongoing legal action involving Star Ratings measures
- What Medicare Advantage organizations should monitor as the program evolves
Key Findings from the 2027 Star Ratings
The Market Remains Relatively Stable Overall
The enrollment-weighted average Overall Star Rating declined from 4.08 in 2026 to 4.01 in 2027. Enrollment in 4+ Star contracts fell from 73.2% to 71.7% after normalizing, contrary to CMS reports of stable enrollment.
This decline reflects two structural forces: while overall contract performance improved between measurement years, measure-level cut points increased at a faster rate, causing a net decline in the percentage of the market reaching 4.0 Stars.
Large Organizations Experienced Sharply Different Outcomes
The 10 largest parent organizations account for approximately 27.8 million members, or roughly 80% of the Medicare Advantage market. Their results varied dramatically.
Humana and Kaiser showed strong gains: Humana experienced substantial improvement with a contract of more than 2 million members moving from 3.5 to 4.0 Stars, while Kaiser maintained 100% of its membership in 4.0-Star-or-higher plans for the third consecutive year. However, these gains mask steeper declines elsewhere. Because Humana and Kaiser account for significant 4+ Star enrollment, their performance actually obscures the more pronounced deterioration experienced by other major organizations.
HCSC, for instance, experienced a 47.6% decline in 4+ Star enrollment after one of its largest contracts fell from 4.0 to 3.5 Stars, a loss that far exceeds the market-wide decline when considered in isolation.
SNP Enrollment in 4.0-Star-or-Higher Plans Declined
Special Needs Plans experienced a more difficult year than the broader market. Enrollment in SNP contracts earning 4.0 Stars or higher declined dramatically from 78% in 2026 to 55% in 2027, a 23-percentage-point drop far steeper than the overall market experienced.
Because enrollment is concentrated among a small number of large organizations, changes in a few major contracts can have an outsized impact on the overall SNP results.
State-Level Results Were Highly Uneven
The change in Star Ratings varied substantially by state.
South Dakota, Montana, and North Dakota experienced the largest increases in enrollment in 4.0-Star-or-higher contracts. Rhode Island, Tennessee, and Louisiana experienced the largest declines.
These shifts demonstrate why national averages can obscure meaningful market-level and regional changes.
Litigation Adds Uncertainty to Future Star Ratings
The 2027 ratings year follows multiple legal challenges involving the Star Ratings methodology and measure set. This white paper identifies 27 measures, representing approximately two-thirds of the program’s weight when duplicate Part C and Part D measures are counted once, for which questions have been raised about their legal status.
For Medicare Advantage organizations, the outcome of ongoing litigation could affect future measure sets, hold-harmless provisions, and many other components in the calculation of overall Star Ratings.
Why This Analysis Matters
Achieving 4.0 Stars remains strategically important because it can trigger a meaningful increase in plan payments through the Quality Bonus Payment program.
That threshold makes Star Ratings performance more than a quality score. It influences revenue, benefit design flexibility, competitive positioning, enrollment strategy, and the need for corrective action when a contract falls below the bonus threshold.
The 2027 results reinforce the importance of analyzing Star Ratings at multiple levels:
- Market-wide performance
- Parent organization results
- Contract-level movement
- SNP performance
- State-specific changes
- Measure-level cut points
- Legal and regulatory developments
Who Should Read This Report
This report is intended for:
- Medicare Advantage executives
- Chief actuaries and actuarial teams
- Star Ratings and quality leaders
- Medicare product and market strategy teams
- Finance and revenue leaders
- SNP executives
- Government affairs and regulatory teams
- Boards and senior leaders evaluating Medicare Advantage performance
Frequently Asked Questions
What changed in the 2027 Medicare Advantage Star Ratings?
The overall market showed meaningful decline when analyzing with consistent, normalized enrollment. The enrollment-weighted average Overall Star Rating fell from 4.08 to 4.01, and enrollment in 4+ Star contracts dropped from 73.2% to 71.7%. This decline is more pronounced than it appears at the surface due to significant improvements by Humana offsetting steeper losses elsewhere in the market.
How did 4.0-Star-or-higher enrollment change in 2027?
Contrary to CMS reports of stable enrollment, enrollment in 4+ Star contracts actually declined from 73.2% to 71.7% when normalized to consistent 2026 enrollment figures and adjusted for 2027 plan crosswalks and terminations. This decline reflects rising measure-level cut points that outpace plan performance improvements.
Why are 4.0 Stars important for Medicare Advantage plans?
Reaching 4.0 Stars can increase benchmark rates through the Quality Bonus Payment program, making the threshold financially and strategically important for Medicare Advantage organizations.
What happened to SNP Star Ratings?
SNP enrollment in contracts earning 4.0 Stars or higher experienced a sharper decline than the overall market, dropping from 78% in 2026 to 55% in 2027, a 23-percentage-point decrease that signals significant performance challenges in this segment.
How is litigation affecting Medicare Advantage Star Ratings?
Recent litigation has raised questions about the legality and future use of certain Star Ratings measures. It may affect future measure sets, hold-harmless provisions, and many other components of Overall Star Rating calculations.
