Skip to main content

White paper

Risk adjustment and Star Ratings success

Discover 5 strategies health plans can implement now to navigate the intersection of risk adjustment and Stars.

In the ever-evolving healthcare landscape, changes are on the horizon for the Centers for Medicare and Medicaid Services (CMS) Star Ratings Quality Measures program. With the 2026 Star Ratings release, CMS will factor risk adjustment metrics into overall Stars performance.

The integration of risk adjustment with quality measures will require health plans to break down silos. These efforts will foster collaboration and leverage data to improve performance. With major shifts underway, achieving and sustaining 4+ stars will require organizations to further evolve an enhanced member-centric approach.

Read this white paper to discover how health plans can take steps now to influence future Star Ratings, including:

  • Breaking down silos to successfully integrate quality, analytics and risk management teams
  • How to better invest in member engagement through coordinated activities
  • Ideas for building health equity through member engagement
  • Ways to effectively close data gaps and improve accuracy to gain credit for performance

Related healthcare insights

View all

Video

Transforming your revenue cycle with Optum Integrity One

Watch how Optum Integrity One supports providers with a more connected, efficient approach to coding and revenue cycle management all in one solution.

Report

Optum recognized as market leader by HFS Horizons

Optum has been recognized as a market leader among health care service providers in the 2026 HFS Horizons: HCP Service Providers, 2026 report.

Article

How we’re advancing the future of healthcare payments with AI

Optum Financial is exploring ways to leverage AI and other advanced technologies to connect healthcare payments and information for a simpler experience.