With the new year marking the official start of another record-breaking year for Medicare Advantage (MA) enrollment, this week’s graphic takes a look at MA star ratings. Star ratings indicate for consumers the quality of an MA plan and determine for payers the bonus payments their plans receive. The average MA star rating increased from 2019 through 2022 then decreased from 2023 through 2025. These highs were eroded away by the expiration of pandemic-era adjustments and changes to cut points that made it more challenging to attain 4 and 5 star ratings. Throughout this entire period, however, provider-sponsored health plans (PSHPs) have consistently earned higher star ratings than their competitors. The average star rating for a PHSP in 2025 is 3.75, which compares favorably to the 3.58 average for BUCCAH plans (referring to six of the largest traditional payers), and a 3.67 average for all other plans. PSHPs are likely reaping the benefits of vertically integrating their payer and provider arms, better positioning them to offer higher-quality plans and outperform their rivals. The continued popularity of MA with seniors has only increased competition and growth among MA plan providers, with the number of MA contracts increasing nearly 30% between 2020 and 2025. Notably, consumers continue to prioritize the selection of high-quality MA plans, with more than 60% of enrollees selecting 4-star-or-higher plans for 2025. Although not necessarily the right fit for all providers, PSHPs have a distinct competitive advantage in a market that clearly values quality, lending them the potential to be part of a successful growth strategy for health systems.
