Improving Your 2026 MA Star Ratings: Insights and Recommendations

The release of the 2025 Medicare Advantage (MA) Star Ratings in October saw results trending downward for the third year in a row. Approximately 32% of plans saw a decrease in their rating, while 29% saw an increase.

This downward trend, though not precipitous, is still cause for some concern. Of the 42 measures that the Centers for Medicare & Medicaid Services (CMS) uses to calculate Star Ratings, MA plans need to pay particular attention to those that are assigned greater weight. Here are three of the key areas of performance that MA plans should focus on to improve their 2026 Star Ratings.

1) Member Experience

Member experience continues to reign with six measures, each weighted at four. As of Stars 2025, 34% of a health plan's rating is based on the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey scores. Rule changes for 2026 will reduce the impact of CAHPS measures by half.

2) Outcomes

The outcome measures, including Diabetes Care Blood Sugar Controlled and Controlling Blood Pressure, continue to be important and remained heavier weighted at three. The Plan All-Cause Readmissions was a new measure released in 2024. For 2025, the measure weight for readmissions will increase from one to three. Plan All-Cause Readmissions performance depends in large part on its lead measure, Transitions of Care, which emphasizes engagement and medication reconciliation post an inpatient stay.

Member experience and outcomes are uniquely intertwined. Studies have shown that patients’ perceptions of support, respect and understanding lead to improved adherence. While chronic conditions continue to drive costs, prevention presents the opportunity for intervention before disease. Therefore, preventive care measures should not be ignored.

3) Medication Adherence

For Part D measures, the three Medication Adherence measures are also more heavily weighted at three. Many plans have invested in pharmacy-based interventions. Addressing the barriers to medication adherence is complex and requires an understanding of members’ socioeconomic status, care access, concerns and other issues.

New Health Equity Index

Looking ahead, CMS has initiated a framework to achieve health equity. CMS defines health equity as “the attainment of the highest level of health for all people, where everyone has a fair and just opportunity to attain their optimal health regardless of race, ethnicity, sexual orientation, gender identity, socioeconomic status, geography, preferred language, or other factor that affect access to care and health outcomes.”

The health equity index will replace the current reward factor used to determine bonus payments. The 2024 reporting year will be the initial data from plans used by CMS and other stakeholders to document social risks. Plans should have already begun stratifying populations to identify members who are dually eligible, disabled and low-income. Targeted programs must be in place to support these members. Addressing social factors is especially challenging and presents new opportunities for plans to support its members in holistic ways.

Jamie Jenkins, Ph.D., is strategic advisor for Government Relations at Pager Health, a technology platform company that connects patients, members and healthcare teams.