Skip to main content

White paper

Risk adjustment and Star Ratings success

Discover 5 strategies health plans can implement now to navigate the intersection of risk adjustment and Stars.

In the ever-evolving healthcare landscape, changes are on the horizon for the Centers for Medicare and Medicaid Services (CMS) Star Ratings Quality Measures program. With the 2026 Star Ratings release, CMS will factor risk adjustment metrics into overall Stars performance.

The integration of risk adjustment with quality measures will require health plans to break down silos. These efforts will foster collaboration and leverage data to improve performance. With major shifts underway, achieving and sustaining 4+ stars will require organizations to further evolve an enhanced member-centric approach.

Read this white paper to discover how health plans can take steps now to influence future Star Ratings, including:

  • Breaking down silos to successfully integrate quality, analytics and risk management teams
  • How to better invest in member engagement through coordinated activities
  • Ideas for building health equity through member engagement
  • Ways to effectively close data gaps and improve accuracy to gain credit for performance

Related healthcare insights

View all

Article

Advancing health equity: How Optum Rx Is overcoming challenges

Thought leaders discuss the intentional vigilance needed to overcome obstacles impeding better access to healthcare for all.

Video

Enhance system security with cloud-native imaging solutions

Learn about the in-depth security capabilities of cloud-native imaging.

Article

What’s changing the PBM industry? ///

Learn from Optum Rx thought leaders how access, affordability and transparency have become imperatives for pharmacy benefit management.