Plan Preview 2: Cut Point Trends and Where to Focus for Q4

The Centers for Medicare & Medicaid Services (CMS) released Plan Preview 2 for the 2027 Star Ratings on September 8, 2026. After comparing all 41 measures that were in place SY2026 and SY2027, the following was observed:

• 25 became harder to reach: Increase in cut points average, or decrease for lower is better measures
• 11 became easier: Decrease in cut points average, or increase for lower is better measures
• 5 held steady: Limited movement in cut points average

A plan that held performance flat this year lost ground on more than half its measure set without doing anything different.

Where guardrails aren’t protecting plans

Guardrails are supposed to soften big swings, capping year-over-year cut point movement at 5 percentage points, or 5 percent of the restricted range. But that cap only applies to measures that have been in the program more than three years, and it never applies to CAHPS or the improvement measures. Seven measures have no guardrail at all for Star Rating 2027, and several of them also jumped to be 3-weighted this year.

 Kidney Health Evaluation for Patients with Diabetes (KED) shows what that looks like in practice. Its cut points climbed an average of 11 percentage points from 2026 to 2027, more than double what a guardrail would have allowed.

Measures uncapped through MY2027, like KED, belong in the fourth quarter push this year. Measures uncapped through MY2028 should shape 2027 targets instead.

The work ahead splits into two timelines

For what's left of 2026, re-forecast the current measurement year against the new cut points and see where each measure lands if performance holds, including which measures still have a half-star within reach and which ones are at risk of losing one. Most KED misses come from the urine albumin-creatinine ratio rather than eGFR, and that gap can still be closed this quarter, often faster with an in-home test kit than waiting on an office visit.

For MY2027, set targets off the top of the national distribution rather than this year's cut points. HOS outcome measures are now 3-weighted, and the CY2027 Final Rule keeps shifting weight toward HEDIS and member experience for 2028 and 2029.

Member experience carries more weight with each rating cycle. Programs that track sentiment year-round, and target the physical health, mental health, and access issues behind HOS and CAHPS, pay out over more than one year rather than just this quarter.

Where Healthmine plugs in

Strategy support
Our Stars advisory team lives and breathes Stars data, partnering one-on-one with Medicare Advantage plans to understand current performance, set against past performance trends and indications of where CMS is going next. We help plans come up with a 360-degree engagement strategy that works across quality, risk, compliance, marketing and finance, setting plans up for multi-year success.

Right now, following Plan Preview 2, we’re helping clients understand what they need to do in the next 90 days, now that we have cut points for context. We do not recommend waiting any longer, especially not until final Star Ratings are delivered in October.  

Tactical execution
On the operational side, Healthmine’s QRM® platform pairs health actions with rewards and omnichannel campaigns to close gaps like KED. QRM Connect™ handles provider matching and scheduling to get screenings coordinated at scale and close more care gaps. Healthmine’s direct integration to the leading HEDIS vendor keeps gap lists current without waiting on trigger files.

Ready to start focusing your Q4 efforts? Reach out to us today.