STAT+: Medicare Advantage star ratings trigger new bonuses, and uncertainty

Humana is a winner, while Alignment signaled it will sue over its downgrade Rachel Leathe/AP Bob covers the money in health care, focusing on health insurance and hospitals. His stories delve into Medicare Advantage, opaque prescription drug benefits, and how much executives actually make. He is also the author of the Health Care Inc. newsletter. You can reach Bob on Signal at bobjherman.09. The federal government has released new quality ratings for Medicare Advantage insurers for 2027, with Humana emerging as the biggest winner. But deep uncertainty remains around Medicare Advantage quality measures, which come with tens of billions of dollars in extra revenue for the highest-performing plans. One health insurance company, Alignment Healthcare, has already threatened to sue the government after its star ratings were downgraded — a now-common occurrence for almost any insurer that is unhappy with its grades. Nearly 71% of Medicare Advantage enrollees are currently in a plan that will have at least four out of five stars for quality, according to the Centers for Medicare and Medicaid Services. Getting at least four stars triggers bonuses, which total $13 billion across the industry annually. Ratings for 2027 lead to bonus payouts in 2028. STAT+ Exclusive Story Already have an account? Log in This article is exclusive to STAT+ subscribers Unlock this article — and get additional analysis of the financial innards of our health care system — by subscribing to STAT+. Already have an account? Log in View All Plans To read the rest of this story subscribe to STAT+. Subscribe Business of Health Care Reporter Bob covers the money in health care, focusing on health insurance and hospitals. His stories delve into Medicare Advantage, opaque prescription drug benefits, and how much executives actually make. He is also the author of the Health Care Inc. newsletter. You can reach Bob on Signal at bobjherman.09.