The recent announcement of 2021 CMS STAR ratings revealed that several MAPD and PDP plans have struggled to keep pace with increasing performance standards and shifting measure weights. In the most recent year, approximately 22% of plans experienced a reduction in overall STAR ratings. Declining performance among Part D measures contributed in large part to a drop in overall STAR ratings and the loss of 4+ STAR ratings by more than thirty plans.
As plans dropped below the 4 STAR threshold, their loss of quality bonus payments (QBPs) will have a significant revenue impact on financial performance. Further loss of 4+ STAR rating may impact membership attrition and growth forecasts. These challenges are just the beginning, as final rule changes to STAR weights will increase the importance of consumer experience driven measures including patient experience and complaint measures as well as measures capturing access. As such, health plans looking to future STAR ratings performance for 2023 and beyond will need to focus more on creating sustainable systems.
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The State of Transformation for U.S. Healthcare Providers
January 26, 2026
Market dynamics for health systems are shifting. The most significant driver is the federal Medicaid mandate, which expired at the end of December 2025 and is now pending legislation. This uncertainty is prompting health system leaders to rethink strategy and operations. In this context, we’ll share how other health systems are responding and what these changes mean for organizations like yours.
Strategic Agility for Healthcare Leaders: Building Resilience Amid Disruption
January 12, 2026
The healthcare industry stands at a critical crossroads, grappling with an era of profound disruption and uncertainty. Over the past two decades, the pace of change has accelerated dramatically, reshaping the competitive landscape and challenging the ability of all stakeholders to adapt.
Provider-Sponsored Health Plans: Bridge or Anchor?
December 17, 2025
Provider-sponsored health plans are no longer neutral—they either create enterprise value or drain capital. This analysis gives CFOs and CEOs a clear framework to decide whether to scale, partner, restructure, or exit.
The 2026 Transformation Imperative- Integrated Strategies for Hospitals, Health Systems and Provider-Sponsored Health Plans
November 13, 2025
The next 12–18 months will test hospital and health system leaders like never before. Transformation isn’t a buzzword anymore—it’s the work that will define who thrives in 2026 and beyond.
