Healthcare DIVE January 5, 2026
For health plans across the U.S., Star Ratings are more than just a score, they’re a lifeline. These ratings, published annually by the Centers for Medicare and Medicaid Services (CMS), help beneficiaries compare the quality of Medicare Advantage (MA) and Part D plans. But for health plans, they’re a direct link to financial reimbursement, market competitiveness and even survival.
How Star Ratings Work
Each year, CMS evaluates health plans on up to 40 measures, ranging from readmissions and transitions of care to follow-up after emergency visits. These measures are scored on a 1–5 star scale, with “cut points” set by CMS to determine performance thresholds. Plans that fall below 3 stars risk being dismissed from the Medicare Advantage...
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