2025 Star ratings projections and the Reward Factor trends

Reward Factor Trends and 2025 Star ratings projections

Medicare Advantage Star Ratings PP2 Cutpoints are out, and the final 2025 Star Ratings are scheduled to release in October, ahead of the AEP. Many in the industry are wondering what we can tell now from the available data about how the 2025 Stars average scores and average industry performance will look.

BHA analyzed historical RF percentile thresholds and compared them with the Stars average scores (average scores and weighted average scores).

Key observations:

• Average Star Ratings scores have been declining for the past two years.

• The RF thresholds (65th percentile and 85th percentile) have also seen a downward trend since the 2022 high, and PP2 estimates seem to be signaling a potential continuation of the downward trend for plans with increasing difficulty to achieve higher scores.

• The 2025 RF thresholds released in the latest technical specifications depict the same story. Both 65% and 85% thresholds are lower—even lower than the 2019 Stars level.

• This could signal that average Star Ratings in 2025 could be significantly lower than the 2024 Stars.

  • This expected lowering of average Stars can also be confirmed by the more difficult-to-achieve cutpoints observed in the 2025 PP2 release.

BHA can help!

• As health plans and vendors brace for the lower Stars, we can help you.

• Plan, simulate, and track your Stars improvement with our Stars suite of apps. Reach out to support@baltimorehealthanalytics.com and start a conversation on improving your Stars.