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CMS Unveils 2026 Medicare Advantage Star Ratings, Shaping 2027 Payer Revenues

The scores determine quality bonuses that will drive Medicare Advantage revenue in 2027.

CVS Health logo is seen in this illustration taken, February 11, 2025. REUTERS/Dado Ruvic/Illustration/File Photo

Overview

  • CVS Health’s Aetna leads with about 81% of members in 4- or 5‑star plans, followed by UnitedHealthcare at roughly 78%, Elevance near 55% and Humana around 20%, according to companies and CMS data.
  • Elevance recorded one of the biggest gains year over year, while UnitedHealthcare was roughly flat, Aetna declined from 2025 levels, and Humana’s share of members in highly rated plans fell.
  • Weighted average star scores ticked up to an estimated 3.98 from 3.96, according to TD Cowen, even as higher thresholds made top ratings harder to achieve.
  • Oppenheimer estimates 64% of people in Medicare Advantage plans with drug coverage are enrolled in contracts rated four or five stars for 2026.
  • Clover Health’s largest contract dropped below 4 stars, which analysts said could cost the insurer tens of millions of dollars, while Centene lifted members in highly rated plans from about 1% to more than 11%.