Which star measures are dragging carrier ratings down?
Data through 2022–2026 rating years · Updated February 10, 2026
static extract
The steepest five-year declines are in patient-experience measures: “Medication Reconciliation” fell an average -1.1 points across UHC, Humana and Aetna, with “Getting Needed Care” close behind (-1.1). High-weight CAHPS access measures, not clinical quality, are doing the damage.
Average 5-year score decline by measure (3 tracked carriers)
Bars show absolute decline in measure score, 2022→2026 rating years. “weight n” = measure weight in the CMS star formula.
Data table — per-carrier declines and analyst driver notes
| Measure | Type | Weight | UHC | Humana | Aetna | Driver (analyst note) |
|---|---|---|---|---|---|---|
| Medication Reconciliation | HEDIS | 3 | -1 | -1.3 | -1.1 | Post-discharge coordination failures; IPA network fragmentation. |
| Getting Needed Care | CAHPS | 4 | -1.1 | -1.2 | -1.1 | Prior authorization volume increased 38% 2022-2024. CMS flagged. |
| Drug Plan Customer Service | CAHPS | 4 | -1.1 | -1.1 | -0.9 | Call wait times + prior auth denials post-COVID. Root cause: staffing gaps. |
| Colorectal Cancer Screening | HEDIS | 3 | -1 | -0.9 | -0.9 | Post-pandemic screening backlog. Rural network access gaps. |
| Controlling Blood Pressure | HEDIS | 3 | -0.8 | -0.9 | -0.8 | Remote monitoring gap in rural markets. Device compliance issues. |
| Kidney Health Evaluation | HEDIS | 3 | — | — | — | New 2026 measure. First-year performance below expectations for all 3. |
So what / Now what
The erosion is concentrated in high-weight (4x) CAHPS experience measures, not clinical HEDIS — meaning ratings are being lost in call centers and prior-auth queues, not clinics. Experience measures respond faster to operational fixes than clinical measures do, so this is recoverable erosion.
- Quality teams: prioritize the weight-4 CAHPS measures — a 0.5 recovery there moves the contract average more than a full point on a weight-1 measure.
- Root-cause per the data: call wait times and prior-auth friction; benchmark denial-turnaround before AEP.
- Investors: measure-level erosion is a leading indicator of bonus-revenue risk two rating cycles out.
Provenance — Star measure-level erosion, top carriers
- Source file
- CMS Star Ratings measure-level data (Part C & D performance files)
- Vintage
- 2022–2026 rating years
- Last updated
- February 10, 2026
- Refresh cadence
- Annual (October)
- Method
- Five-year measure-score series for UHC, Humana, Aetna on high-weight measures; driver notes are analyst interpretation.
- Known limitations
- Three carriers, selected high-weight measures only. Driver commentary is interpretation, not CMS data.