Why Star Ratings Matter and Why We Need Your Support

Why Star Ratings Matter and Why We Need Your Support

Every October, Medicare Advantage plans receive a CMS Star Rating based on the care and experience they provided their members in the previous year. This rating is 1 to 5 stars with 5 stars being the highest performing. Higher-performing plans receive higher rebate rates from CMS; plans that are 4-star or better also receive bonus payments. These resources help us continue to keep plan premiums and member cost shares low and provide essential supplemental benefits that support overall health and well-being. 

Our 2025 Star Rating

Our plans that serve 98% of our membership received a 4-star rating for 2025 (based on performance from 2023). CMS continues to make changes to the Star Rating program that reduces the number of 5-star plans. This year, the number of plans earning a 5-star rating dropped from 38 in 2024 to 7 out of the 521 that received a rating. 

Your Role in Star Ratings

Now, more than ever, we need your support. Over 57% of the overall Medicare Star Rating is made up of measures that can be impacted by our members’ providers. Some of the areas you influence include:

• Cancer screenings: breast and colorectal screening
• Disease management: A1c control, blood pressure control and kidney screenings for patients with diabetes, eye examinations for patients with diabetes, and prescribing statins as appropriate to those with cardiovascular disease or diabetes
• Patient experience: support access with routine and acute care needs
• Medication adherence: Diabetes, hypertension, and statin medications
• Preventing readmissions
• Discussing important health topics: like physical activity, urinary incontinence, and falls

We Appreciate Your Support

The work you do can help stabilize our 4-star rating and ensure we can continue to provide competitive, high-quality health plans to our members/your patients. Every phone call, office visit, gap closed, and record received can make a huge difference. 

Thank you for supporting our goal of ensuring every member receives the affordable coverage and care that supports their best health. We cannot achieve this success without YOU.