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Cut points for 2026 Medicare Advantage plans look challenged, analysts say

ReutersSep 10, 2025 4:41 PM

Leerink Partners, citing published data in a LinkedIn post, said criteria for Medicare plans to earn bonus payments "look challenged"

The post refers to Centers for Medicare and Medicaid Services' cut points which are thresholds used to determine "Star", or quality ratings, for Medicare Advantage plans

There are concerns that tougher cut points in Medicare Advantage star ratings could hurt bonus payments in 2027 - Morningstar analyst Julie Utterback

Elevance ELV.N shares slip 1.8% to $307.73, while UnitedHealth UNH.N and Humana HUM.N down marginally

Brokerage Leerink adds in a note that it appears 58% of cut points got harder, 17% easier and 25% stayed same

For 2025, 70% of measures got harder, 12% easier and only 18% with no change, brokerage says

Star ratings sway enrollees' choice of plan and determine government's reimbursement levels

CMS did not immediately respond to a Reuters request for comment

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