LeadingAge sent a letter to the Medicare Payment Advisory Commission (MedPAC) on December 19 requesting a meeting to discuss potential changes to the Five Star Quality Rating System on Nursing Home Care Compare.

MedPAC is a nonpartisan independent legislative branch agency that advises Congress on the Medicare program. MedPAC holds public meetings to discuss policy issues and vote on recommendations to Congress, which are presented through two reports to Congress annually, in March and June.

In a December 2025 MedPAC public meeting, the Commission discussed potential changes to the Five Star Quality Rating System (referred to as “Five Star” hereinafter) on Care Compare. Commissioners reviewed current scoring methodology and weighting of Five Star, then explored two alternative options presented by Commission staff.

One alternative weighted all three domains of Five Star evenly, while the second alternative weighted the staffing domain most heavily, then weighted the health inspection and quality measures domains equally at a lesser weight. These alternatives can be viewed in the presentation beginning with slide 14.

LeadingAge has requested a meeting with MedPAC staff to share additional insights on Five Star and discuss any potential future changes prior to recommendations being made to Congress and the Centers for Medicare and Medicaid Services (CMS).

We encourage members to weigh in on this topic. Please email Jodi Eyigor jeyigor@leadingage.org with your thoughts on the current scoring methodology and weighting of the Five Star Quality Rating System and any ideas you may have for improvement. We also welcome any feedback on the two alternatives proposed by MedPAC during the December 2025 public meeting.

MedPAC’s next public meeting will be held January 15–16, 2026. An agenda for this meeting and a link to register for the telecast will be posted here approximately one week prior to the meeting.