This week we published a very cool Infographic on the Medicare Advantage-Part D 2025 Star Year and trends from the past. You can take a look at it here: https://lilacsoftware.com/2025-medicare-advantage-stars-infographic/ .
Here are some of my key takeaways from the great analysis done by Lilac Software’s data scientists.
Star performance is demonstrably down – See “Overall Star Rating Distribution for MA-PD Contracts” and “Overall Star Rating Movements”
MA Star performance is demonstrably down since 2022. The average overall Star rating is down from 4.37 in 2022 to 3.92 in 2025, the lowest it has been since 2015. The number of contracts that achieved 4 Star and greater is down from 322 in 2022 to 209 in 2025. The percentage of enrollees in 4 Star or greater contracts is down from 89.7% in 2022 to 62.2% in 2025.
Showing drops at the 5 and 4 Star level, the number of contracts scoring 4.5 and 3.5 went up from 2024 to 2025.
About one-third of all contracts saw drops in their overall rating. Just over one-quarter of contracts saw increases in their rating.
See our blog here for more insights on why Stars dropped, in great measure due to the poor performance of big national plans: https://lilacsoftware.com/stars-2025-analysis-ad-findings/ .
Star drops by performance category – See “Overall Star Ratings Movements”
Lilac bundled high performers as 4.5 and 5 Stars, medium performers as 3.5 and 4 Stars, and low performers as 3 Stars and below. We found that the number and proportion of 4.5 and 5 Star plans have dropped dramatically from 2022 to 2025, going from 168 in 2022 to 92 in 2025, a 45 percent reduction. For 3.5 and 4 Star plans, the count has increased (from 268 in 2022 to 277 in 2025) but the proportion decreased over the timeframe. For 3 Star and below plans, the count increased from 27 in 2022 to 146 in 2025, which is a 441% increase. The proportion increased dramatically as well.
Average scores for measures mixed – See “Average Star Rating By Measure”
Average scores for measures are mixed from 2024 to 2025. From 2024 to 2025, 19 measures saw their scores drop, 16 saw them increase, and 7 saw them stay the same.
If almost as many measures went up and down, why such a major drop in overall scores? Because 11 of the 19 measures that went down had weights of 3, 4, or 5. In terms of those that improved, just 8 has weights of 3, 4 or 5. It is also true that measures that declined collectively had bigger drops than those that increased.
The 5x-weighed Part C improvement measure did leap from 2.9 to 3.6 from 2024 to 2025, with the 5x-weighed Part D improvement measure dropping from 3.4 to 3.3 from 2-24 to 2025. But the Part C improvement leap was not enough to offset the overall Star rating drops.
Biggest measure struggles – See “Data Deep Dives”
Plans had tremendous success driving some measures and major difficulty with others. Note that far more contracts struggled with declines than drove improvements, which is consistent with the overall drop in Star scores.
More plans seemed to have success driving results for Transitions of Care, Plan All-Cause Readmissions, Medication Adherence for Statins, Getting Appointments and Care Quickly, Rating of Health Care Quality, MTM Comprehensive Medication Review, Rating of Drug Plan, and Follow-up ED. The movement on TRC, Readmissions, and Follow-up ED is a good sign as these have been major struggle points. The two improvement measures also moved up for many plans (although the average score for Part D was down.)
On the flip side, more plans struggled with the two Call Center measures, Controlling Blood Pressure, MPF Price Accuracy, Drug Plan Quality Improvement, Colorectal Cancer Screening, Diabetes Care Eye Exam, Breast Cancer Screening, Reducing the Risk of Falling, and Stain Therapy for Cardiovascular Disease.
The Call Center measures are very controversial for the small number of qualifying events and discretion the Centers for Medicare and Medicaid Services (CMS) has in assessing the measures. In Star Year 2024, Elevance Health successfully litigated a change in its Call Center scores. United Healthcare is suing CMS this year on Call Center metrics. Humana has appealed many of its scores, presumably including Call Center as well.
Conclusion
This is the third year for major drops in overall Star scores for MA-PDs. It represents the second year of very bad news for MA plans. We now have the lowest average overall score – below 4.0 – since 2015. Just 62% of enrollees will be in 4 Star or greater contracts in 2025. We have seen a major drop in performance among the highest performing plans since 2022.
Plans appear to have very mixed performance on individual measures, able to drive some higher, but missing the mark on more of them. This caused overall measure scores to drop.
