Health · Healthcare & Policy · 2 days ago
Humana gains in 2027 Medicare Advantage ratings as Alignment falls
The US government has released quality ratings for Medicare Advantage plans for 2027.
Medicare Advantage is a private insurance option for people enrolled in Medicare.
Humana sharply increased the share of its members in plans rated at least four out of five stars, from 41% in 2026 to 93% in 2027.
That level matters because plans rated at least four stars qualify for extra payments and other advantages.
The ratings will shape bonus payments in 2028, and Humana could gain billions of dollars in extra revenue.
Alignment Healthcare had the opposite result: its largest contract fell below four stars, leaving 25% of its members in plans above that threshold, down from 98%.
Alignment says the rating does not reflect its performance and may challenge the government’s methods through legal action.
The Centers for Medicare and Medicaid Services released 2027 Medicare Advantage star ratings on Thursday, October 8, 2026.
Humana’s share of members in plans rated at least four stars rose from 41% in 2026 to 93% in 2027, according to Healthcare Dive’s analysis.
The ratings affect bonus payments, and plans with at least four stars qualify for higher bonuses; payments based on 2027 ratings will be adjusted in 2028.
Alignment Healthcare’s largest contract fell below four stars, leaving 25% of its members in plans above that threshold for 2027, down from 98% currently.
Alignment said the rating does not accurately reflect its performance and said it may challenge the CMS measures and methodology in court.
- Who
- The Centers for Medicare and Medicaid Services, Medicare Advantage insurers including Humana and Alignment Healthcare
- What
- The CMS released 2027 Medicare Advantage quality star ratings, affecting insurers’ bonus payments.
- When
- Ratings released Thursday, October 8, 2026; payment adjustments based on them are due in 2028.
- Where
- United States
- Why
- Star ratings determine eligibility for higher bonus payments and can affect insurers’ revenue and competitive position.
Alignment Healthcare
Centers for Medicare and Medicaid Services
Whether Alignment’s rating reflects its performance
Alignment Healthcare
Alignment argued that its downgraded rating does not accurately reflect its performance.
Centers for Medicare and Medicaid Services
The CMS issued the rating under its star-rating system, which assesses plans on quality measures.
The rating methodology
Alignment Healthcare
Alignment questioned the agency’s measures and methodology and said it may pursue administrative remedies and litigation.
Centers for Medicare and Medicaid Services
The CMS changed its methodology for 2027, adding measures, changing the weights of existing measures, and raising many quality-score thresholds.
We intend to pursue all available administrative remedies and to litigate the measures and methodologies we believe warrant review
clear win for a company that has been working toward this outcome for several years
This story does not have a timeline yet.
- Humana members in 4+ star plans
- 41% in 2026; 93% in 2027
- Alignment members in plans above the 4-star threshold
- 98% currently; 25% in 2027
- Alignment membership
- About 280,000 members in five states
- Industrywide bonuses
- $13 billion annually, according to STAT
- Payment timing
- Payments adjusted based on 2027 ratings in 2028
Sources
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