Turn Insights into Action with Your 2025 Star Rating Results

The release of the 2025 Star Ratings marks a critical moment for Medicare Advantage plans. After months of hard work, the results are finally in; and with them comes both validation and, for some, surprise. Whether your plan celebrated higher ratings this year or saw unexpected declines, the real question is: What’s next?

We believe the publication of Star Ratings is not the finish line. It’s the beginning of the next performance cycle. The insights hidden in your results can guide how you engage members, partner with providers, and invest in the tools that will carry your plan forward.

If Your Plan Earned Strong Ratings

Positive ratings should absolutely be celebrated. High scores translate into stronger market positioning, higher quality bonus payments, and a clear signal to members that they can trust your plan. But momentum matters, and it’s important to keep moving forward.

Double down on what’s working. Look at the measures where you excelled. Was it preventive screenings, medication adherence, or member experience? Make those processes part of your organizational DNA by embedding them into workflows and training.

Leverage your ratings for growth. Strong performance is a competitive advantage during open enrollment. Use your results in marketing campaigns, member communications, and broker education to stand out in the marketplace.

Don’t rest on your laurels. Star Ratings are recalculated every year, and what worked in 2025 might not guarantee success in 2026. Use this period of strength as an opportunity to experiment with new programs, pilot member engagement strategies, or deepen partnerships with providers.

High performance is a gift, but only if you protect it with consistent attention and forward-looking investment.

If Your Plan Faced Unexpected Challenges

A lower-than-expected Star Rating can feel discouraging, but it’s not the end of the story. In fact, some of the most successful plans today once struggled with disappointing results before turning things around. The key is to act quickly, with focus and clarity.

Pinpoint the problem areas. Use measure-level detail to identify exactly where the shortfalls occurred. Was it CAHPS scores? Medication adherence? Gaps in care management? Granular analysis is critical for targeting interventions.

Strengthen provider engagement. Many Star measures hinge on provider performance, from ensuring patients receive follow-up care to improving medication adherence. Engaging providers with timely, actionable data can drive measurable improvement.

Rebuild member trust. If experience scores pulled your rating down, this is a chance to listen more closely. Focus groups, surveys, and proactive outreach can reveal what members need and help you design programs that show you’re committed to their satisfaction.

Modernize your tools. Legacy systems often make it difficult to see issues until it’s too late. Platforms like our Quality360™ solution give plans a real-time view of where members and HEDIS® measures stand, so corrective action can happen continuously rather than annually.

Design a comeback strategy. A low score doesn’t define your plan forever. With targeted initiatives and technology support, it’s possible to see measurable improvement in as little as one to two cycles. Many plans also find value in bringing in outside expertise to accelerate recovery. UST HealthProof’s Star consulting services help identify root causes, prioritize interventions, and create tailored action plans that balance compliance, member satisfaction, and provider engagement.

The key is to treat poor ratings as a call to action rather than a setback. With the right strategy, recovery is well within reach.

Turning Ratings into Roadmaps

Regardless of whether your plan saw success or faced challenges, the most important mindset shift is this: Star Ratings are not a report card, they’re a roadmap. Each measure tells a story about how members experience care, how providers deliver services, and how your organization supports both.

We help health plans move from a once-a-year reaction cycle to a continuous improvement mindset. By harnessing integrated data, real-time analytics, and automated workflows, plans can respond to issues as they arise and create sustained improvements that will show up in future ratings. Our Star consulting services complement these tactics by providing strategic guidance to translate insights into practical steps; helping plans strengthen their Stars strategy with both operational execution and long-term vision.

Star Ratings aren’t just numbers on a page, but insights into what members need, where providers need support, and how your plan can stand out in a crowded market.

3 Key Takeaways

1. High scores are momentum builders. Celebrate success but focus on sustaining and scaling what’s working.

2. Low scores are an opportunity. Use the data to identify gaps, engage providers and members, and put a focused recovery plan in motion.

3. Ratings are a roadmap. With modern tools and continuous improvement, your plan can turn today’s results into tomorrow’s competitive advantage.