CMS last week released its Medicare Advantage (MA) Star Ratings for 2026, with just over 40% of MA contracts earning at least four stars.

Methodology

For this year's ratings, CMS analyzed at least 45 quality measures across five different domains:

• Outcomes, which include improvements in a patient's health and help assess quality of care
• Intermediate outcomes, which include actions that can help improve a patient's health
• Patient experience, which includes patients' perspectives on the care they received
• Access, which includes processes and issues that could create barriers to care
• Process, which includes healthcare services that can help patients maintain, monitor, or improve their health status

For the 2026 MA Star Ratings, CMS adjusted the weight of certain measures and added new measures on improving or maintaining physical health, improving or maintaining mental health, and more. CMS administrative data, data collected by CMS contractors, data from health and drug plans, and surveys of enrollees were used for the ratings.

Across the top 10 MA insurers, most saw slight decreases in the number of MA contracts that earned four stars. Four insurers, UnitedHealthcare*, Elevance Health, Health Care Service Corp (HCSC), and Centene, saw increases in the number of MA contracts rated at least four stars.

Commentary

According to industry analysts, there were no major surprises in this year's MA Star Ratings, and stock reactions after the ratings were published were minimal.

However, Ryan Langston, an analyst at TD Cowen, said that plans that saw their ratings decrease will see lower payments from CMS, which could cause them to cut supplement benefits or increase premiums to protect their margins — something that several major insurers are already doing to combat flagging profits.

Several large insurers, including Humana and Aetna, have also pulled their MA plans from certain counties and states to help recover margins. Currently, large payers are prioritizing MA plans with narrower networks and designs that pass more costs to consumers.

It's also possible that some insurers will choose to sue CMS over its MA Star Ratings. In 2025, at least seven organizations sued CMS over their ratings, though most were unsuccessful at getting their ratings increased.

*Advisory Board is a subsidiary of UnitedHealth Group, the parent company of UnitedHealthcare. All Advisory Board research, expert perspectives, and recommendations remain independent.