At Impresiv, we know the pressure of Star Ratings has never been higher. The Centers for Medicare and Medicaid Services (CMS) released Medicare Advantage star ratings in October, showing an average score of 3.65 for 2026, down from 3.92 in 2025. Standards continue to rise, measurement is increasingly outcomes-focused, and scoring updates shift the landscape every year. Plans are under pressure to do more with less: deliver a better member experience, improve data accuracy, reduce costs, and drive stronger health outcomes.

For many plans, putting a tactical improvement plan in place can feel overwhelming. The real challenge lies in understanding which operational levers you can pull for real, measurable improvements. This year, the plans that win will be the ones that make Star improvement part of daily operations and leverage real-time data to act quickly. This blog explores five operational moves that truly move the needle, and how plans can position themselves to perform better year after year.

A Quick Refresher on CMS Star Ratings

Star Ratings are CMS’s annual system for evaluating the quality and performance of Medicare Advantage and Part D plans on a 1-to-5-star scale. CMS evaluates plans using up to 40–45 measures across five different areas:

• Clinical outcomes 
• Intermediate outcomes 
• Patient experience 
• Access 
• Process

Scoring pulls from several data sources, including HEDIS, HOS, CAHPS, administrative data, and pharmacy claims. CMS also assigns different weights to measures, which dramatically impacts your overall score:

• Improvement measures = weight 5
• CAHPS member experience = weight 4
• Medication adherence and intermediate outcomes = weight 3
• Most administrative, process, and clinical process measures = weight 1

This weighting means even slight performance dips in the wrong areas can have a huge impact. And a one-star shift can result in millions in lost bonus payments and rebates, reduced benefit flexibility, and lower enrollment tied due to reputation damage. 

Let’s look at five operational moves your plan can make to strengthen your rating next year.

1. Prioritize High-Weight Measures That Can Swing Your Score

The fastest way to protect or improve your Star Rating is to focus on measures with the highest weights, because these measures anchor your entire score. 

Your highest-impact measures are:

• Improvement Measures: Flat year-over-year performance hurts your score, even if your overall performance looks strong.
• CAHPS Measures: A drop here can easily pull a plan from 4+ Stars into the low 3’s.
• Medication Adherence & Intermediate Outcomes: CMS is doubling down on driving better outcomes for patients with chronic conditions by improving medication adherence, blood sugar control, blood pressure, etc.

How to prioritize these high-weight measures:

• Build a “Top 10 Priority Measures” list at the start of the year and ensure all teams know where to focus.
• Assign executive owners to each high-weight measure who can monitor performance, recognize trends, and develop improvement plans.
• Implement weekly or bi-weekly performance monitoring for medication adherence, CAHPS early-warning indicators, and chronic condition outcomes. 
• Refocus resources from low-weight measures to high-impact ones. Improving a few weight-1 measures won’t offset a decline in a weight-4 CAHPS score or a weight-5 improvement measure.
• Integrate high-weight measure tracking into provider scorecards so they can understand their role in Star performance, and you can see which providers need additional support.

2. Attack Your Worst-Performing Measures with a Tactical Plan

Many plans spread themselves too thin by trying to focus on every measure when the reality is, apart from high-weight measures, it’s your lowest-performing measures that drag your entire Star Rating down. A fast path to improvement is to target them aggressively. 

Start by identifying the measures below cut points or trending in the wrong direction, then do root-cause analysis to find what’s driving the issue. Are members not getting the access or benefit education they need? Are there breakdowns in provider workflows? Are documentation errors creating downstream problems? From there, deploy 30, 60, and 90-day action plans. This might mean targeted provider outreach, updating call-center scripts, or fixing improper documentation habits. 

The goal is to raise your worst-performing measures with focused, tactical action.

3. Upgrade Your Data Analytics Game for Real-Time Visibility

To improve high-weight measures, especially CAHPS, medication adherence, and chronic condition outcomes, plans need data that surfaces problems as they happen (not weeks or months later). This means investing in real-time operational analytics that can pull up-to-date data from multiple sources. 

On the clinical side, being able to see who’s overdue for follow-up care or who’s slipping toward non-adherence helps teams step in before it impacts the patient’s health and your measure performance. The same goes for member sentiment. CAHPS declines don’t happen out of nowhere—small frustrations show up first in negative call center interactions, unresolved complaints, and long wait times. Plans that monitor these indicators regularly can catch patterns early, fix the issues, and improve member experience before they become bigger problems.

In short, real-time visibility can help you get the right signals quickly enough to act on them.

4. Hardwire Value-Based, Preventive Care into Operations

Preventive care and chronic condition management play a major role in high-weight Star measures, but they often break down in the day-to-day reality of provider workflows. High-performing plans hardwire preventive care into their operations so screenings and follow-ups happen naturally.

This means supporting providers with simple, repeatable workflows such as standing orders, point-of-care alerts, and post-visit checkouts that automatically schedule follow-ups. It also means making it easier for members to stay on track through proactive reminders, simplified scheduling, digital tools, and clear communication about why certain services matter.

Ultimately, value-based, preventive care becomes much more effective when it’s woven into everyday processes. It makes it easier for providers to close gaps, for members to stay engaged, and for plans to perform well on the Star measures that matter most.

5. Enhance Member Engagement Around CAHPS Drivers

CAHPS measures have the second-highest weight after improvement measures, making member engagement crucial to your final rating. The areas that CAHPS evaluates, like access, timely care, communication, service, and overall experience, are shaped by daily interactions.

High-scoring plans focus on the root drivers of CAHPS scores by reducing scheduling friction, simplifying communication, shortening wait times, and resolving issues quickly. They also keep a close eye on early signals that their member experience is falling short, such as call center volume, repeat complaints, and access barriers. A big part of that is gathering and analyzing feedback year-round. Gathering feedback year-round through short pulse surveys, post-call or post-visit follow-ups, or quarterly check-ins helps identify issues early and protect CAHPS performance long before the official survey.

Bonus: Partner with Experts Who Know Your Operational Realities 

Often the toughest part of improving your Star Rating isn’t knowing what you need to improve, but having the capacity and expertise to actually execute. That’s why many plans turn to partners who understand the real-world, day-to-day pressures behind their operations. 

Impresiv Health helps plans strengthen the operational areas that directly influence Star Ratings, including quality improvement strategy, CMS readiness, care management and utilization management optimization, appeals and grievances, and the technology platforms behind them. Whether it’s optimizing your systems, improving data governance, redesigning clinical workflows, or providing interim leadership and staffing support, Impresiv helps plans close gaps quickly and effectively. 

The right partner can be the difference between staying flat and achieving 4–5 Star performance. Impresiv’s blend of regulatory expertise and hands-on operational support gives plans the lift they need year after year.

Conclusion

The plans achieving high Star Ratings aren’t necessarily the biggest or the most resourced. They’re the ones that focus on high-impact strategies, act quickly, and build everyday operations around improving the measures that heavily influence scoring. If there’s one theme across all five steps, it’s this: improving your Star Rating comes from doing the basics exceptionally well, every single day. Clear priorities. Fast feedback loops. Strong provider partnerships. A real-time pulse on member engagement. When these fundamentals are built into your operations, performance improvement becomes second nature. 

At Impresiv Health, we help health plans do exactly that. Contact us to learn how we can support your journey to stronger, more sustainable performance.