Medicare Advantage (MA) plans overall Star Ratings, released October 8, 2026, by the Centers for Medicare and Medicaid Services (CMS), reveal a decline across all contracts (a grouping of plans).

Only 15 MA contracts earned a 5-star rating, down from 22 in 2026. Despite this decline, 71% of all MA enrollees remain in contracts rated 4 stars or higher.

MA Star Ratings matter because they influence MA plan revenue, enrollment, network decisions, and quality improvement priorities. Plans that achieve at least 4 stars receive a 5% quality bonus and retain a larger share of rebate dollars, which are used to fund supplemental benefits, reduced beneficiary cost sharing, and premium reductions for Part B or D. In addition, ratings can be a big factor in beneficiaries’ evaluation of their MA enrollment options.

What MA Star Ratings don’t shed light on is how a particular plan is performing. Ratings are assigned at the contract level, and a single contract may contain a multitude of individual MA plans. This approach allows high-performing plans to obscure weaker performers, a practice about which LeadingAge has repeatedly expressed concerns.

For example, one UnitedHealthcare 5-star contract includes 25 Institutional Special Needs Plans (I-SNPs) operating across multiple states, as well as 30 retiree group plans. While the contract receives a single 5-star rating, the performance of the individual plans within that contract is publicly unknown.

Financial Winners and Losers

The ratings carry significant financial consequences for MA plans because they determine eligibility for quality bonus payments and how much rebate a plan will receive beginning in 2028.

Humana emerged as one of the biggest beneficiaries of the 2027 results. Approximately 93% of its plans received ratings of 4 stars or higher, up from 41% in 2026 and 25% in 2025. According to Healthcare Dive, the improvement could generate $3 billion or more in additional revenue for the company in 2028.

UnitedHealthcare had mixed results. The percentage of its enrollees in plans rated 4 stars or higher fell from 81% to 67.9%, although the company still maintains three 5-star contracts that will be designated “high performing” on Medicare Plan Finder, which could boost enrollment in those plans.

Longevity Health I-SNP contracts also could see an enrollment benefit by holding five of the fifteen 5-star contracts for 2027, as well as strong corresponding revenue.

Aetna also experienced a decline, with enrollment in 4-star-or-higher plans dropping from 85.1% to 70.2% and its Aetna Better Health of California Inc. contract, which currently serves more than 9,000 enrollees, will receive a “low performing” icon on Medicare Plan Finder.

Similarly, Alignment Healthcare saw six of its seven plans achieve ratings of 4 stars or higher but that doesn’t help much when most of its membership is enrolled in a California contract that fell to 3.5 stars, eliminating eligibility for a quality bonus payment and potentially creating enrollment pressures.

MA organizations whose contracts’ Star Ratings declined below 4 stars, may feel additional financial pressure with the loss of the 5% quality bonus and may apply that pressure to provider rate negotiations.

However, the opportunity for providers is to examine where those MA organization’s quality measure weaknesses are and make a case for how they can help them strengthen their performance in the coming year.

Contracts are listed in the 2027 Star Ratings Data Tables.

What the Ratings Mean for Providers

Star Ratings provide insight into the quality measures MA organizations are emphasizing and where plans may seek provider collaboration to improve performance.

Several important measures declined year over year, including:

• Improving or Maintaining Physical Health
• Monitoring Physical Activity
• Blood pressure control
• Diabetes care measures related to eye exams and kidney health evaluations
• Follow-up after an emergency department visit for individuals with multiple high-risk chronic conditions

These declines highlight ongoing challenges in preventive care, chronic disease management, and care coordination, areas where aging services providers can play a significant role.

There were also notable improvements in: Plan All-Cause Readmissions (2.9 to 3.4 stars), and Transitions of Care (3.1 to 3.4 stars). These gains reinforce the importance of effective discharge planning, communication across care settings, and post-acute care coordination.

CMS incorporated several new or revised measures into the 2027 ratings, including:

• Concurrent Use of Opioids and Benzodiazepines
• Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults
• Care for Older Adults – Functional Status Assessment (revised)

These measures reflects CMS’s continued emphasis on medication safety and functional outcomes for older adults.

CMS shifted how it evaluates plans on appeals-related measures. For the first time, CMS used Part C Reporting Requirements data to validate information received from Independent Review Entities (IREs) for:

• Plan Makes Timely Decisions about Appeals
• Reviewing Appeals Decisions

As a result, 2027 ratings show a slight decline in plans’ performance on timely appeal decisions, while performance on reviewing appeal decisions improved modestly.

Finally, nonprofit MA organizations continue to outperform for-profit organizations on Star Ratings. According to CMS, approximately 44% of nonprofit MA-PD contracts earned ratings of 4 stars or higher, compared with 34% of for-profit MA-PD contracts.

Enrollment Implications

Star Ratings can influence beneficiary enrollment decisions. Beginning this fall, the 2027 ratings will appear on Medicare Plan Finder, where beneficiaries compare MA plan options.

Individuals enrolled in lower-rated plans may:

• Switch plans during the Annual Enrollment Period (October 15 through December 7)
• Change MA plans during the MA Open Enrollment Period (January 1 through March 31)
• Use the 5-Star Special Enrollment Period, available to beneficiaries who have access to a 5-star plan in their service area

Because ratings affect both plan reputation and financial performance, providers should expect MA organizations to continue focusing heavily on the quality measures that drive Star Ratings and to seek provider partners that can help improve outcomes in these areas.

For LeadingAge members, the ratings offer an important signal of where MA plans are succeeding, where they are struggling, and where opportunities exist to strengthen partnerships around quality, care coordination, and member outcomes.