CMS Stars Ratings
Medicare Advantage Star Ratings — Contract Year 2026 (Based on MY 2025 Data)
Overall CMS Star Rating
4.0
out of 5 Stars
★★★★★
Prior Year Rating
3.5 ★
Year-over-Year Change
+0.5 ★
5-Star Bonus Status
Not Achieved
Double Bonus Eligible
Eligible
Part C Clinical
4.5
★★★★½
8 measures
Above Avg
Part D Med Safety
4.0
★★★★★
4 measures
On Track
Patient Experience
3.5
★★★½★
CAHPS survey
Needs Work
Access & Availability
4.0
★★★★★
3 measures
On Track
Measure-Level Performance
| Measure | Domain | Current Stars | Rate % | % to Next Star | Weight | YoY Change |
|---|---|---|---|---|---|---|
| Breast Cancer Screening | Part C Clinical | ★★★★★ 5.0 | 79.4% | — | 3x | +0.5 |
| Colorectal Cancer Screening | Part C Clinical | ★★★★★ 5.0 | 82.1% | — | 3x | +1.0 |
| Blood Pressure Control | Part C Clinical | ★★★★ 4.0 | 68.7% | 4.1% → 5★ | 3x | +0.5 |
| Diabetes HbA1c Control | Part C Clinical | ★★★ 3.0 | 61.2% | 8.8% → 4★ | 3x | -0.5 |
| Annual Wellness Visit | Part C Clinical | ★★★★ 4.0 | 71.8% | 3.2% → 5★ | 1.5x | +0.5 |
| Care for Older Adults | Part C Clinical | ★★★★★ 5.0 | 83.7% | — | 1x | +0.5 |
| Statin Use — Cardiovascular | Part C Clinical | ★★★★★ 5.0 | 84.5% | — | 1x | +0.5 |
| Osteoporosis Management | Part C Clinical | ★★★ 3.0 | 63.8% | 6.2% → 4★ | 1x | 0 |
| Drug-Drug Interactions | Part D Med Safety | ★★★★★ 5.0 | 96.2% | — | 3x | 0 |
| High-Risk Medications | Part D Med Safety | ★★★★ 4.0 | 88.4% | 2.1% → 5★ | 3x | +0.5 |
| Adherence — Diabetes Meds | Part D Med Safety | ★★★ 3.0 | 77.2% | 7.8% → 4★ | 3x | 0 |
| Rating of Health Plan (CAHPS) | Patient Experience | ★★★ 3.5 | 72.4% | 5.6% → 4★ | 4x | 0 |
| Getting Needed Care (CAHPS) | Access | ★★★★ 4.0 | 81.3% | 4.7% → 5★ | 2x | +0.5 |
Top Improvement Opportunities
Diabetes HbA1c Control
8.8% improvement needed for 4★ → Impact: +0.25 overall
CAHPS Health Plan Rating
5.6% improvement needed → Impact: +0.20 overall (4x weight)
Adherence — Diabetes Meds
7.8% improvement needed → Impact: +0.15 overall
Blood Pressure Control
4.1% improvement needed for 5★ → Impact: +0.10 overall
Impact Calculator
If all high-priority measures improve by target amount:
4.5 ★
Projected overall rating (+0.5)
Revenue impact (5★ bonus)
+$2.4M
Enrollment growth projection
+8-12%
Quality bonus payment
+$180 PMPM