The draft 2027 Star Ratings cut points landed in your plan preview this week, and the news inside them is not gentle. About half of the thresholds moved up, a third held roughly where they were, and only 17 percent eased, so if your performance held steady this year, your rating still has a real chance of slipping. Nearly all of the tightening sits on HEDIS® measures, and the official ratings post in early October, which leaves you a short window to work with the numbers before they become the ones your members, your brokers, and your competitors see.
Two things are worth holding onto as you read. These are preview cut points rather than final ones, so the figures below describe direction and magnitude rather than a settled outcome. And the preview window exists for a reason, since it is your opportunity to check your own data against what the Centers for Medicare & Medicaid Services (CMS) has and raise a flag before publication.
What the draft file shows
Newton Smith Group ran the draft cut points and sorted the movement into three groups, as reported by Healthcare Dive. Roughly 50 percent of cut points increased, and those increases cluster in HEDIS®. Roughly a third held flat, and those sit mostly in CAHPS. The remaining 17 percent got easier, a group padded by three measures leaving the set altogether, so the genuinely easier list is shorter than the percentage makes it look.
Melissa Newton Smith, the firm’s founder and a longtime voice on the RISE stage, put her read plainly. “The average payer leader should be very worried. Very worried.” She added, “There are very few tailwinds sitting in stars right now,” and if you are building your own read of the preview file, the missing tailwinds are the part worth sitting with. In a normal year you expect a handful of measures to drift your way and quietly offset the ones drifting against you. This year those offsets are thin.
Analysts have already started pricing the movement in. Whit Mayo projected UnitedHealthcare’s largest contract might slip from 4.5 to 4 stars without performance gains, with Humana’s ratings holding relatively stable, and both projections run against draft thresholds rather than results. If any of your contracts sit near a half-star boundary, you know the exercise well, and this year it is less forgiving than usual.
Where the pressure landed
Two HEDIS® measures moved far enough to reshape a contract on their own, and both fall into the category where operational discipline usually pays off for you.
Kidney Health Evaluation for Patients With Diabetes rose 7 to 10 points depending on the star level, and the structure of the measure is what makes a jump of this size sting. KED asks for two tests in the same measurement year for your members with diabetes, an estimated glomerular filtration rate and a urine albumin-creatinine ratio, and a member with one test but not the other counts as a full miss rather than a partial win. If your outreach has been built around eGFR, which tends to travel along with routine lab panels, you have been doing most of the work and collecting none of the credit, and these thresholds now charge you for the gap.
Colorectal Cancer Screening tightened 4 to 11 points, and the width of the range tells you more than any single number inside it. An 11-point move at one star level means the field compressed hard at that boundary, so a rate sitting comfortably above last year’s line has a genuine chance of falling below the new one. Pulling your own colorectal rate and laying it against both years is a small piece of work with an outsized payoff in how confidently you plan the rest of the fall.
Why the bar rises when you do better
For anyone newer to the mechanics, and this question comes up on nearly every Stars call, CMS does not decide thresholds in advance. It takes contract-level performance for the year, clusters it, and draws the lines where natural breaks fall in the distribution, so your bar is set by what your peers achieved rather than by a fixed standard. A rate of yours holding flat while the field gains ground is a decline in relative terms, and the rating scores your relative position.
Guardrails soften some of this by capping movement at 5 percentage points in either direction, with two exceptions worth knowing before you model anything. Guardrails apply only to measures carrying at least three years of data, and they do not apply to new or substantively updated measures. A move of 7 to 10 points on KED therefore points to a measure sitting outside guardrail protection, so confirming that measure’s history in the technical notes is a sensible first step.
The CAHPS stall works against you as well
A flat CAHPS reads like good news at first glance, and it is not quite. Newton Smith called the stagnancy surprising: “Every indicator outside of CAHPS itself indicate that consumers and their doctors are very dissatisfied.” When survey thresholds stop moving, the survey measures stop separating contracts from one another, and a set of measures no longer distinguishing anyone also stops being a place where you gain ground. Whatever half star you are chasing, the swing vote now belongs to HEDIS® and pharmacy, and your investment mix over the next two quarters is worth revisiting with that in mind.
The short window, and the longer one behind it
Your 2027 rating rests on the measure set you already have, since the contract year 2027 final rule removed 11 administrative measures and none of those removals reach 2027. Two inputs decide it. The first is your measurement year 2025 performance, closed and submitted. The second is where CMS drew the lines, now visible to you in the preview. One of the two is settled, and the other deserves a careful afternoon with your analytics team.
Between now and early October, the productive work is verification rather than improvement. Reconcile your submitted rates against the preview file, check your enrollment and your contract crosswalks, and file corrections through the process CMS provides, because plans have found real errors in this window and a corrected denominator has been worth a half star before.
The improvement runway is longer and friendlier than the headline suggests. Measurement year 2026 runs through December 31, and both KED and colorectal screening respond well to late-year outreach, since each turns on an annual test where a member closed in November counts exactly the same as one closed in March. Reading a 10-point threshold jump today still leaves you a full quarter to move your measurement year 2026 rate, and measurement year 2027 has not started for anyone. If you are behind on these two measures, you have real room to work with. If you are ahead, the assumption worth retesting is the one where you stay ahead, because the field keeps improving and the lines keep moving with it.
RISE will model cut-point movement, recalculate weighted measure portfolios, and stress-test your paths to the next threshold in the Stars Reshuffled panel at The 16th Annual HEDIS® & Quality Improvement Summit, November 3-5, in Baltimore. The measure-by-measure work groups include dedicated sessions on KED and on Colorectal Cancer Screening plus Follow-Up After Positive Non-Invasive Test (COL-E/COF-E).