The Centers for Medicare & Medicaid Services just dropped its proposed rules for the 2027 Medicare Advantage and Part D contract year, and the theme is pretty clear: less busywork, more focus on what actually matters for patient health.

The agency says these updates should sharpen the program's value for both beneficiaries and taxpayers while setting the stage for future reforms centered on innovation and better health outcomes. CMS is also asking for public input on where Medicare Advantage should head in the coming years, including ideas for modernizing care models and redesigning benefits to better support patient health.

Star Ratings Get Streamlined

The biggest piece of this proposal is a major overhaul of the Star Ratings system, which helps beneficiaries compare plan quality and determines which plans get Quality Bonus Payments and rebates. Right now, Medicare Advantage plans with prescription drug coverage are rated on up to 43 measures, Medicare Advantage-only plans on up to 33, and Part D plans on up to 12. These measures cover everything from outcomes and patient experience to process and access.

CMS is making some substantial changes to this framework. First, the agency is pulling the plug on the Excellent Health Outcomes for All reward—previously called the Health Equity Index—for the 2027 Star Ratings cycle. Instead, CMS will stick with the existing reward factor that recognizes plans consistently delivering high performance across quality measures.

More importantly, CMS plans to cut 12 process-heavy or administrative measures where plan performance has become uniformly high. When everyone's doing well on a metric, it stops being useful for comparison, so these measures are getting the boot for lacking meaningful variation.

Mental Health Gets Attention

On the flip side, CMS is adding a new Part C Depression Screening and Follow-Up measure. This will start with the 2027 measurement year and factor into the 2029 Star Ratings, specifically targeting persistent gaps in behavioral health care. The goal here is to push plans to focus more on clinical care, measurable outcomes, and patient experience while reducing administrative burden around metrics that no longer help differentiate performance.

Easier to Switch Plans Mid-Year

The proposal also tackles enrollment flexibility. CMS is recommending a new special enrollment period specifically for Medicare Advantage members whose providers leave their plan's network mid-year. The change removes the requirement that beneficiaries prove the network change was "significant," making it simpler to switch plans and stick with preferred doctors.

Additionally, CMS plans to formally codify its longstanding policy requiring prior agency approval for certain special enrollment periods.

The agency is now collecting feedback on these proposals as it works to refine how Medicare Advantage operates going forward.