BALTIMORE, MD — About 71% of Medicare Advantage enrollees are in health plans rated four stars or higher for 2027, according to federal ratings released October 8 by the Centers for Medicare & Medicaid Services, establishing quality assessments that will influence insurers’ 2028 bonus payments and help beneficiaries compare coverage during the upcoming enrollment period.
The results show that 188 Medicare Advantage contracts offering prescription drug coverage, approximately 37% of those available in 2027, earned at least four stars. Those contracts account for a substantially larger share of enrollment than their share of rated plans.
The ratings will appear in Medicare Plan Finder ahead of the annual open enrollment period, which runs from October 15 through December 7, 2026.
CMS evaluates Medicare Advantage and standalone prescription drug plans annually using measures of clinical quality, patient experience, medication management and administrative performance. Ratings range from one to five stars.
The assessments carry financial consequences for Medicare Advantage insurers because the 2027 results will affect quality bonus payments in 2028.
Standalone Medicare Part D prescription drug plans showed a notable improvement in the share of beneficiaries enrolled in highly rated contracts.
Approximately 22% of standalone drug plan enrollees are currently in contracts that earned at least four stars for 2027, compared with 2% in 2026.
Eleven standalone prescription drug contracts, representing approximately 27% of those active in 2027, received ratings of four stars or higher.
CMS also identified 15 Medicare Advantage prescription drug contracts that earned five-star ratings. Six had received the same distinction the previous year.
Four Medicare Advantage contracts received low-performing designations for consistently poor quality ratings, unchanged from the previous year.
The results also showed differences in performance between nonprofit and for-profit insurers.
Approximately 44% of nonprofit Medicare Advantage prescription drug contracts received at least four stars, compared with 34% of for-profit contracts.
Among standalone prescription drug plans, the corresponding figures were approximately 28% for nonprofits and 27% for for-profit organizations.
CMS also found that Medicare Advantage contracts with at least 10 years of program participation generally earned higher ratings than newer contracts.
The 2027 assessments incorporate changes to how insurers are evaluated, including new measures examining concurrent opioid and benzodiazepine use and the use of multiple anticholinergic medications among older adults.
CMS also increased the weighting of measures evaluating whether beneficiaries maintain or improve their physical and mental health, making those outcomes more consequential in overall ratings.
Other revisions include updated colorectal cancer screening criteria and changes to measures involving care for older adults. Certain medication review and care coordination measures were removed or temporarily excluded from the ratings.
Medicare Advantage contracts offering prescription drug coverage were evaluated on as many as 43 measures, while Medicare Advantage plans without drug coverage were assessed on up to 32. Standalone prescription drug plans were evaluated on up to 13 measures.
For beneficiaries, the ratings provide a standardized way to compare plan performance alongside premiums, benefits and other coverage costs.
The 2027 results are available through Medicare Plan Finder, with additional technical information at http://go.cms.gov/partcanddstarratings.
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