Members arrive January 1. What happens to your star rating?
A new contract has no star rating, which means no quality-bonus rebate for its first years. But the measurement periods start immediately — CAHPS and HOS reflect member experience from the first month.
Your year-one operations are your year-three rating.
What this stage actually is
The stage where a launch becomes a business, and where the decisions that look operational turn out to be strategic two years later.
What you must do
- Onboard members. Health risk assessments, PCP assignment, care management enrollment. The first 90 days set the year’s utilisation and satisfaction trajectory.
- Stand up the risk-adjustment cycle — encounter data submission, accuracy, RADV readiness. Payment depends on it and errors compound.
- Capture star measures from day one, particularly the survey-based ones you cannot fix retroactively.
- Run the compliance programme — appeals and grievances timeliness, provider directory accuracy, Part D reporting, formulary administration.
- Reconcile enrollment and payment monthly against your bid assumptions.
A CY2027 planning note
CMS finalised the removal of several Star Ratings measures beginning with the 2027 measurement period, shifting relative weight toward survey-based and clinical-outcome categories, while requiring plans to keep reporting removed measures through CMS’s plan-comparison tools. For a new plan, that raises the weight of member experience — the hardest thing to repair after the fact.
Key dates
| What | When | Date status |
|---|---|---|
| Coverage effective | Jan 1 | statutory |
| MA Open Enrollment Period | Jan 1 – Mar 31 | statutory |
| Star Ratings published | Each October, for the following plan year | pattern |
| Next cycle’s application | ~Feb, while you operate year one | projected |
About the dates on this page. CY2027 dates are published CMS facts. CY2028 dates marked statutory are fixed by regulation. Dates marked projected are the pattern from the CY2026 and CY2027 cycles — CMS has not published them yet, and we relabel them the day it does. How we label data and dates →
CMS forms, systems and references
- Star Ratings technical notes
- Part C and Part D reporting requirements
- Risk adjustment and encounter data guidance
- Managed Care Manual — grievances, organisation determinations, appeals
Common mistakes
- Enrollment materially under bid, which breaks a fixed-cost model. Have a 50%-of-target plan ready before January.
- Treating stars as a year-three problem. CAHPS and HOS lag two years.
- Encounter data gaps, which surface as a revenue shortfall you cannot recover.
Tips for success
- Instrument the first 90 days heavily. It is the only clean baseline you will ever have.
- Reconcile membership monthly against the bid, not quarterly.
- Start the next cycle’s application work in January. Year two overlaps year one entirely.
The data you need for this stage
- Star movement — measure-level erosion patterns across the industry
- Market intelligence — monthly enrollment for reconciliation against your own actuals
So what / Now what
The star clock starts before you have a rating. Everything you do in year one is being measured for a rating that publishes in year three, and member experience is the part you cannot retrofit.
- Design the first-90-days onboarding sequence before January, not after.
- Stand up encounter data submission and reconciliation from month one.
- Watch industry measure erosion in Star movement to see where peers lose points.
Provenance — sources and date status
- Source files
- Medicare Managed Care Manual, Chapter 11; CY2027 MA and Part D Final Rule; CY2027 Rate Announcement; CY2027 Part D Bidding Instructions
- Vintage
- CY2027 cycle published; CY2028 cycle not yet posted by CMS
- Last updated
- July 24, 2026
- Refresh cadence
- At each CMS cycle milestone (application posting, Advance Notice, Rate Announcement, final rule)
- Method
- CY2027 dates are transcribed from CMS materials. CY2028 dates are either statutory (bid = first Monday in June; Rate Announcement = first Monday in April; ANOC receipt = Sep 30; marketing start = Oct 1; AEP = Oct 15–Dec 7) or projected from the CY2026 and CY2027 cycle pattern.
- Known limitations
- Projected dates are not CMS commitments and must be confirmed against the CMS application page and HPMS memos when the CY2028 cycle opens. Network adequacy standards and application procedures change between cycles — verify current-cycle instructions rather than reusing prior-year guidance.
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