Overview of Humana’s 2026 Star Ratings
Humana disclosed significant information regarding its Medicare Advantage (MA) star ratings for 2026 on Thursday, revealing that approximately 20% of its membership base is currently enrolled in plans rated at four stars or higher. This announcement comes as healthcare insurers await the official release of comprehensive star ratings data from the Centers for Medicare & Medicaid Services (CMS), which plays a crucial role in determining plan quality and bonus payments.
The star ratings system serves as a critical benchmark for Medicare Advantage plan performance, influencing both member enrollment decisions and insurer revenue streams. Higher star ratings—particularly those achieving 4.0 stars or above—qualify plans for quality bonus payments from CMS, making these ratings financially significant for health insurance companies.
Key Performance Metrics
Enrollment Distribution by Star Rating
According to Humana’s filing with the Securities and Exchange Commission (SEC), the preliminary data reveals the following enrollment breakdown:
- 1.2 million members enrolled in plans with at least four stars
- 14% of total membership currently in plans rated at 4.5 stars
- Average star rating of 3.61 across all Humana Medicare Advantage plans
- 80% of members enrolled in plans below the four-star threshold
What These Numbers Mean
The average star rating of 3.61 represents a performance level that falls short of the premium four-star category, which is essential for maximizing quality bonus payments. While having 20% of members in high-performing plans demonstrates some success, the majority of Humana’s Medicare Advantage enrollment remains in lower-rated plans, presenting both challenges and opportunities for improvement.
Preliminary Data Release
Inadvertent CMS Data Exposure
The star ratings information became available through an unexpected channel. Humana noted in its SEC filing that the 2026 star ratings data “was inadvertently accessible on CMS Plan Finder for a period of time” on Wednesday. This premature access allowed the insurer to analyze its performance before the official public release.
This unintentional data exposure highlights the complexities of managing sensitive healthcare information and the eagerness with which insurers await these critical performance indicators. The Medicare Advantage star ratings directly impact competitive positioning in the marketplace and influence member retention and acquisition strategies.
Company’s Strategic Response
Acknowledging Dissatisfaction
Humana explicitly stated in its filing that while the company is “not satisfied” with the 2026 results, there were significant constraints on improvement efforts. The insurer experienced a downturn during the 2025 plan year, which limited the time available to implement substantial performance enhancements for 2026.
Diversification Strategy
To address these challenges, Humana is implementing a comprehensive diversification strategy for its Medicare Advantage contracts. This approach focuses on:
- Spreading risk across multiple plan types and configurations
- Expanding geographic coverage areas
- Enhancing care coordination programs
- Improving member engagement initiatives
- Investing in quality improvement measures
The company anticipates that this diversification will yield positive results, though the benefits will materialize gradually over subsequent rating periods.
Future Outlook and Expectations
2027 Star Ratings Projection
Humana expressed optimism about future performance, particularly for the 2027 star ratings cycle. The company expects “meaningfully higher” ratings for 2027, as those scores will reflect the improved plan distribution and enhanced quality measures being implemented now.
Near-Term Improvements for 2026
Despite the preliminary 2026 ratings being based on current enrollment patterns, Humana also expects its diversification efforts to positively impact actual 2026 performance. The company has focused on strategic plan design and benefit enhancements that should drive member satisfaction and clinical outcomes.
Membership Growth Projections
Based on its strategic initiatives and the information available, Humana anticipates returning to membership growth in 2026. This projection suggests confidence that despite lower star ratings, the company’s benefit offerings and market positioning remain competitive.
Financial Impact and Guidance
2025 Financial Guidance Reaffirmed
With the star ratings data serving as context, Humana reaffirmed its 2025 financial guidance of approximately $17 per share. This confirmation indicates that the preliminary star ratings performance aligns with the company’s multiyear financial planning assumptions.
The reaffirmation suggests that:
- Management had anticipated these rating levels
- Financial models account for lower bonus payments
- Strategic investments remain on track
- Long-term growth trajectory remains intact
Conclusion
Humana’s 2026 Medicare Advantage star ratings present a mixed picture—while 20% of members enjoy high-quality four-star-plus plans, the overall average of 3.61 indicates substantial room for improvement. The company’s transparent acknowledgment of dissatisfaction, combined with concrete diversification strategies and reaffirmed financial guidance, demonstrates a balanced approach to addressing current challenges while positioning for future success. As the healthcare industry awaits official CMS data release, Humana’s preliminary results offer valuable insights into the competitive Medicare Advantage landscape.
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