Yesterday, CMS issued its final rule on Medicare Advantage (MA) policy for Contract Year 2027. The rule includes updates on beneficiary cost-sharing, modifications to the MA Star Ratings program and other programmatic changes. AHPA will provide a full summary in the next Policy Brief; in the interim, here are some top-level highlights:   

  • Overall Star Ratings Changes: Removes 12 Star Ratings measures it deems are topped out, in hopes to focus Star Ratings scores more on clinical outcomes and patient experience. 
  • Health Equity Index Pause: Chooses not to implement the Health Equity Index (“Excellent Health Outcomes for All”) for the 2027 Star Ratings, pausing the explicit bonus this would have provided. Instead, CMS will continue to use the historical reward factor; the final rule asserts this is a pause in implementation. Any permanent repeal will be proposed in future rule making. 
  • New Depression Screening Measure: Adds a new Depression Screening and Follow-up measure.