MA Star ratings 2025—Who are the winners and losers?

Analyses of 2025 Medicare Advantage star ratings continue to pour in and not all of it bodes well for the conventional juggernauts.

Insurtechs Alignment Healthcare and Clover Health are some of the happiest program participants while traditional heavyweights and several Blue Cross Blue Shield plans are likely to be displeased with the ratings.

Leading insurers experienced a 0.23 year-over-year decrease in their star ratings, an analysis of the average star ratings for the top 15 MA plans by enrollment by consulting firm HealthScape Advisors, a Chartis Company, found.

The two biggest health plans, UnitedHealth and Humana, fared worse than most in the industry. UnitedHealth’s average star rating decreased by 0.39 and Humana saw the largest drop at 0.74.

CVS Health may be the most likely insurer to acquire former Humana members, an analyst told Barron’s. Nearly 70% of Humana’s members in a plan 4 stars or better is now in a plan rated 3 or 3.5 stars, compared to 88% of Aetna members in a plan 4 stars or better.

BCBS Florida (Guidewell) and BCBS Minnesota also experienced significant drops, though BCBS Minnesota managed to keep its average rating above four stars. Elevance Health has 14% more of its membership in 3- or 3.5-star plans in 2025 than it did in 2024.

But even for companies that did not have as positive results as they wished, investors don’t seem spooked.

UnitedHealth’s and Cigna’s stock prices are largely unchanged. Humana’s stock dipped initially but is now trading 3.26% higher. Elevance’s stock is up 1.99% and Centene is trading 1.62% higher.

Centene has approximately 46% of its members in plans rated 3.5 stars or better, a 23% improvement from last year, the company reported in an 8-K filing. Still, its average star rating is 3.15, down from 3.89 in 2022. It also had the most contracts scoring 2.5 stars or worse among the major competitors.

Analysts and investors are encouraged by Clover’s and Alignment’s star ratings.

Clover has 95% of its members in its PPO offering, a plan that rose from 3.5 stars to 4 stars for 2025. Its stock has risen 2.78%.

“What we’ve been able to accomplish with this year’s star ratings is a manifestation of the foundational improvements we’ve built over the last several years,” said Jamie Reynoso, CEO of Medicare Advantage for Clover, in a statement.

Alignment maintained a 4-star rating for its largest contract in California, which equals 85% of its membership. The company’s HMO contract in North Carolina received a rare 5-star result. Only seven contracts earned a 5-star rating for 2025. Another Alignment PPO contract in California increased from 3 stars to 4.5 stars

Five of the biggest plans in California saw star ratings decline, representing a big opportunity for Alignment to capitalize, said analysts at William Blair.

“We expect a significant level of plan switching in 2025, given the commentary from larger managed care organizations about curtailing benefits and prioritizing margin in bids,” they wrote.

Other California-based insurers, SCAN Health Plan and Kaiser Permanente, increased their star ratings from 4 to 4.5 stars. More than 98% of SCAN’s members are in 4.5-star plans or better, the plan announced following the star ratings release.

In New York City, Healthfirst is now the highest-rated HMO plan available at 4.5 stars.

“Plans that earn 4 stars receive a 5% increase in their benchmark as a quality bonus payment,” said HealthScape in its report. “Moving from 4.5 to 5 stars does not provide a rebate or quality bonus payment advantage. However, plans with 5 stars have a strategic advantage of marketing their products year-round, not just during the short open enrollment period in October through December.

Other individual contracts to receive 5-star ratings are from Highmark Health, Elevance Health, MHH Healthcare and UPMC Health System. Zing Health had one of the lowest-performing contracts.

With open enrollment set to begin Oct. 15, Humana is appealing its scores and UnitedHealth is suing the agency over one call center phone call.

Judges previously sided with SCAN Health Plan and Elevance Health over the Centers for Medicare & Medicaid Services in star-ratings lawsuits.