‘Call Center Blues’ Take Center Stage as CMS Releases 2025 Star Ratings

CMS released its 2025 Medicare Advantage and Part D Star Ratings on Oct. 10, following outcry and legal challenges to its calculations. After applying the Tukey outlier deletion methodology for the second year in a row and recalculating the much-contested 2024 Star Ratings, CMS revealed that 40% of Medicare Advantage Prescription Drug (MA-PD) contracts earned overall ratings of 4 stars or higher, and 62% of enrollees are in plans that will be rated 4 or more stars in 2025. Around 25% of Part D Prescription Drug Plans earned 4 or more stars, and 5% of PDP enrollees are in contracts with 4 or more stars. 

Of the major publicly traded insurers, overall ratings for CVS Health Corp. and Cigna Healthcare (which intends to sell its MA assets to Health Care Service Corp.) were largely unchanged in terms of membership estimated to be enrolled in plans rated 4 stars or higher (69% and 88%, respectively), according to an Oct. 10 research note from Evercore ISI. “This lack of [year-over-year] change provides official validation in what we learned from the MA plan finder last week and provides additional certainty around 2026 earnings and CVS’s longer-term MA margin recovery,” wrote securities analyst Elizabeth Anderson. MA plans that earn 4 stars or more qualify for quality bonus payments in 2026.