Here is what you’ll find in this week’s newsletter!
Important links 🔗 - the best articles we found this week about the Medicare Market along with links to Jared’s recent LinkedIn posts.
Deep Dive 📚 - Star Ratings 2027: Humana Climbs, the Top Tier Thins 🌟
Sponsor Snapshot 🚀 - brought to you by VRI
It’s only a 5-minute read, but it will make you 10x smarter.
Here are IMPORTANT LINKS 🔗 for the week:
CMS: About 71% of MAPD plan enrollees in coverage with four or more stars for 2027 - (link)
Many Medicare Part D Stand-Alone Drug Plan Enrollees Will See Modest Premium Increases for 2027, But Others Could Pay Much More If They Don’t Switch Plans - (link)
Humana soars, Alignment plummets in 2027 Medicare Advantage star ratings - (link)
Fairview sues UnitedHealthcare over alleged Medicare Advantage false advertising - (link)
Alignment Health sues over 2027 star ratings - (link)
CMS Says Medicare Advantage is “Stable” in 2027 (YouTube video) - (link)
Medicare Advantage Plan Availability Varies Widely by County for 2027 - (link)
Charting A Path Forward For Medicare Advantage: Expert Consensus On Policy Priorities And Trade-Offs - (link)
Jared’s recent LinkedIn posts:
UnitedHealth Group (UNH) reported Q3 2026 results this morning. - (link)
The $0 drug deductible is disappearing from Medicare Advantage - (link)
~3.16 million Medicare Advantage members are in a plan that's terminating or losing their county for 2027 - (link)
Medicare Advantage plans going away for 2027 - (link)
11 states have 2027 MA/MAPD plans with Enrollment Caps - (link)
DEEP DIVE 📚
Star Ratings 2027: Humana Climbs, the Top Tier Thins 🌟
Last year brought a small rebound. This year the average held roughly steady, but the leaderboard reshuffled.
The 2027 Star Ratings set Quality Bonus Payments for 2028 and will shape how plans are perceived for the next two enrollment cycles. Who crossed the 4-Star line, and who fell below it, matters more this year than the headline number.
The Big Picture
The enrollment-weighted average Star Rating for MA-PD contracts came in at 3.99 in 2027 vs. 4.01 in 2026. Essentially flat.
The share of enrollees in a 4-Star or higher contract actually rose, from 67% to 71%. Members moved toward better-rated plans during last year’s AEP, and low-rated plans exited. Holding membership constant, contract ratings themselves fell about 0.07 Stars; that member movement offset most of it.
(Based on MMI analysis. 2026 ratings weighted by September 2025 enrollment; 2027 ratings by September 2026 enrollment.)
Shifting the Curve
5-Star contracts: Down from 22 to 15 contracts, with enrollee share steady at about 2%. The largest 5-Star contracts are MCS Advantage (Puerto Rico), Clover, and Triple-S.
4.5-Star contracts: The biggest move. Contracts fell from 89 to 65, and enrollee share dropped 6 points (39% → 33%).
4.0-Star contracts: Fewer contracts (118 → 108), but enrollee share jumped from 26% to 36% as 4.5-Star contracts stepped down and Humana’s 2.3 million-member H5216 stepped up from 3.5.
3.5-Star contracts: Steady at 164 contracts, with enrollee share falling from 25% to 20%.
3.0-Star and below: Up from 120 to 156 contracts, and from 7% to 10% of enrollees.
The curve compressed toward the 4-Star line. More members sit above it than a year ago, but fewer sit comfortably at 4.5, and more sit at exactly 4.0.
—
Carrier-Level Results
The market held steady, but not evenly: Humana surged while UnitedHealthcare and Aetna both fell below a 4.0 average.
Carriers Gaining Ground:
Humana: the comeback story, +0.54 to 4.18, with 4-Star or higher share up 74 points (21% → 95%). Its largest contract, H5216 (2.3 million members), moved from 3.5 to 4 Stars.
BCBS of Michigan: +0.12 to 4.49, with 4-Star or higher share up 12 points (87% → 99%).
Kaiser Permanente: +0.06 to 4.48, still with 100% of members in 4-Star or higher plans.
Clover Health: its main PPO contract, H5141, moved from 4.5 to 5 Stars, earning the year-round enrollment window.
Carriers Losing Ground:
Healthfirst: the steepest drop, –0.89 to 3.48. Its main contract, H3359 (356K members), fell from 4.5 to 3.5 Stars, taking 4-Star or higher share from 88% to 0%.
HCSC: –0.41 to 3.38, with 4-Star or higher share down 35 points (48% → 13%).
CVS/Aetna: –0.23 to 3.99, with 4-Star or higher share down 15 points (85% → 70%).
UnitedHealthcare: –0.19 to 3.93, now averaging below 4.0, with 4-Star or higher share down 13 points (81% → 68%). Roughly 2.9 million UHC members are now in sub-4-Star contracts.
Highmark: –0.04 to 4.30, with 4-Star or higher share down 10 points (95% → 85%).
Rest of Market: –0.11 to 3.91, with 4-Star or higher share down 10 points (73% → 63%).
Elevance and Centene Also Slipped:
Elevance: –0.05 to 3.81, with 4-Star or higher share down 7 points (54% → 47%).
Centene: –0.17 to 3.22, with 4-Star or higher share down 10 points (20% → 10%).
—
Why It Matters
Star Ratings are more than a report card. They drive how much revenue a plan earns, how competitive its benefits can be, and how attractive it looks to members and investors.
Revenue Impact
The 2027 ratings set 2028 Quality Bonus Payments. Plans at 4 Stars or higher qualify for the bonus and a larger share of rebate dollars, which fund richer benefits and lower premiums. With UnitedHealthcare and Aetna together carrying about 4.2 million members in sub-4-Star contracts, the 2028 bid cycle just got harder for two of the three largest MA carriers.
Customer Growth & Retention
Plans with strong ratings tend to keep members longer and grow faster. 5-Star contracts also get a year-round enrollment window, a marketing edge while everyone else waits for AEP.
Market Signal
Investors and regulators watch Star Ratings closely. Humana’s rebound comes a year after it lost its court challenge to its 2025 ratings, and shows a large book can recover within a cycle. Healthfirst and HCSC show how quickly the opposite can happen.
What’s Next
CMS kept the historical reward factor rather than moving to the Health Equity Index for 2027, so this year’s methodology looks a lot like last year’s. The bigger shift comes later: the measure removals finalized in the 2027 rule take effect mostly with the 2029 Star Ratings, which will put more weight on HEDIS and CAHPS.
—
Bottom Line
The 2027 Star Ratings cycle is a reshuffle, not a reset. The market average held near 4.0 (4.01 to 3.99), but the names above and below the 4-Star line changed.
Humana, BCBS of Michigan, and Kaiser moved up. UnitedHealthcare, Aetna, Elevance, Centene, HCSC, and Healthfirst moved down.
For carriers now sitting just under the 4.0 cliff, the 2028 payment year will test how much benefit richness they can protect, and whether they can climb back before the 2029 measure changes reset the scorecard again.
Methodology: Overall Star Rating for rated MA-PD contracts (H and R contracts) from the CMS 2027 Star Ratings and the July 22, 2026 update of the 2026 Star Ratings. 2026 ratings are weighted by September 2025 CPSC enrollment and 2027 ratings by September 2026, so each year reflects the members enrolled when its ratings were released. Carriers are grouped by 2027 parent organization. Contracts rated “plan too new” or “not enough data” are excluded.
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What MMI + Subscribers read this week…
11% of Medicare Advantage enrollees are losing their plan in 2027! 👋- Seven carriers are exiting individual MA entirely, Local PPO disruption climbs to 19%, and Minnesota faces a near-total reset. (link)
Tea Leaves - AEP 2027 🍂 - Repository of 2027 AEP changes / opportunities (link)
Non-Commissionable Plans - Aetna - A look at Aetna's Non-Commissionable Plans for Plan Year 2027 (link)
Insurance Regulatory Insights October 2026 - State bulletins, federal rulemaking, and a fresh round of MA bills — what's final, what's new, and what's moving. (link)
Sept ‘26 MA/MAPD and PDP enrollment data - September enrollment data has been loaded. Here are a few observations. (link)
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