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
Real-Time Transparency Will Transform Healthcare [Report]

Report

Real-time transparency will transform healthcare

Learn how provider organizations can evaluate and implement new AI-powered claim technologies that lower costs and administrative burden.

Partnering with State Medicaid & HHS Agencies for 30 Years

Video

Partnering with state Medicaid and HHS agencies for over 30 years

See how state teams can turn data, responsible AI, and deep Medicaid expertise into insights that support decision-making and human-centered care.

Move Fraud Prevention Upstream With AI Strategies

Article

Stop chasing fraud: Move prevention upstream with AI strategies

How AI, data and investigative expertise are helping health plans detect fraud earlier and stop losses before they occur.