2027 Medicare Advantage Star Ratings Slip: What Home Health Agencies Should Know

CMS released the 2027 Medicare Advantage Star Ratings on Oct. 8, and the headline number looks calmer than the details underneath it. Only about 37% of Medicare Advantage prescription drug contracts (188 of them) earned four stars or higher, down from roughly 44% for 2026. The enrollment-weighted average barely moved, slipping from 4.01 to 3.99, and about 71% of enrollees are still in four-star-or-better contracts. Analysts at HealthScape Advisors point out that much of that cushion comes from one company, Humana, rebounding, while the rest of the market lost ground. For home health agencies that rely on Medicare Advantage referrals and contracts, that split is worth paying attention to.

Why Medicare Advantage Star Ratings matter to home health

Star Ratings are not just a badge on Medicare Plan Finder. They drive quality bonus payments, and the 2027 ratings will shape 2028 bonuses. A Wakely analysis of the early data found that the thresholds plans need to clear dropped notably, a sign of broader decline that it expects to have a material negative impact on 2028 bonus payments. HFMA also notes that insurers are already scaling back plan portfolios amid rising medical and benefit costs. When plan revenue tightens, plans tend to look harder at which post-acute partners help their quality numbers and which ones simply add cost.

Where agencies fit in the picture

Several of the things plans are measured on happen in the weeks after a hospital stay, such as avoiding readmissions and managing care transitions well. That is exactly where home health shows up. CMS also recalculates cut points every year, so plans have to keep improving just to hold their rating. That gives agencies a concrete conversation to have with payers. Instead of promising "high quality," bring evidence: how quickly you start care after a referral, how reliably scheduled visits actually happen, and how cleanly you hand patients back to their physicians.

What to do before the next contract conversation

Start with the plans that send you the most patients and check their new ratings. Open enrollment runs Oct. 15 through Dec. 7, so some members will switch plans and your referral mix could shift in January. Then pull your own numbers for Medicare Advantage patients: referral-to-start-of-care time, the share of planned visits that were completed, and 30-day hospitalizations. CareSync® keeps planned versus completed visits visible in one place, which makes that second number easier to show when a plan asks. The bigger lesson from this year's ratings is that a steady average can hide a lot of movement, and plans under bonus pressure will favor partners who can prove they deliver.

Sources: CMS 2027 Star Ratings fact sheet, HFMA, HealthScape Advisors, Wakely.