Star Ratings 2027: Measures That Reward Follow-Up

Fewer contracts reached four stars in the 2027 Star Ratings, cut points moved harder, and a Health Outcomes Survey measure on mental health is now worth triple. The measures that moved are the ones that depend on reaching members.

Which 2027 Star Ratings measures reward follow-up that actually happens?

Here is the 2027 picture, from the CMS fact sheet and final rule. 188 of 508 MA-PD contracts reached four stars or higher, down from 229 of 516 the year before. About half of the draft cut points moved harder, most of them on HEDIS measures. The Health Equity Index reward was not implemented; CMS kept the historical reward factor. Eleven low-variation measures are being removed between 2027 and 2029.

The weights that changed point in one direction. The survey-based mental health outcome is triple-weighted. A depression screening and follow-up measure is coming. The common thread is whether a member was reached and whether something happened after.

This post sticks to what CMS has published. No measure weights beyond the ones above, and no claims about what any plan's score will do.

Improving or Maintaining Mental Health, triple-weighted

Measure C05 comes from the Health Outcomes Survey, which asks members about their own health and mood rather than reading it from a claim. It returned in 2026 and is triple-weighted from 2027. A plan does not improve a survey-based outcome by writing a letter. It improves it when members with declining mood or cognition are noticed and someone follows up.

The survey population's cognitive status shapes the answer. A member whose cognition is slipping answers differently, and a plan that does not know which members are slipping cannot act on the measure.

The same survey carries Reducing the Risk of Falling. Both ask about something that happened, or did not, between the visits the plan can see.

The cut-point movement sharpens this. When about half of the draft cut points move harder, the same performance earns fewer stars. The measures where a plan can still move are the ones where the member was never reached in the past, because that is where the headroom is.

Depression Screening and Follow-Up, from 2029

The Part C measure counts from the 2029 Star Ratings, which means the members it will score are the members a plan is reaching now. The measure has two halves. Screening is the half most plans already do at the annual visit. Follow-up is the half that depends on someone making contact afterward.

Follow-up is a phone call, and phone calls are where care management runs out of hours. The member who screens positive and then does not answer three times is the member the measure is about.

The lead time is the useful part. A plan that builds a follow-up habit now, and keeps the record of every attempt, will have the habit and the record in place when the measure begins to count in the 2029 Star Ratings.

What Gia does with the members nobody can reach

Gia makes the calls. By phone or video, any phone including a landline, in 44 languages, with retries when nobody answers. No scheduled follow-up silently disappears.

The call is a conversation about how the member is doing. Inside it runs a 40-second speech check-in that measures 2,500 speech biomarkers. How a member sounds today is information no survey captures and no claim records. Results reach care management in under two minutes as a ranked worklist with the reason beside each name.

Where the plan wants more, one click sends Gia back to administer a structured assessment in conversation. For the plan's analytics team, Scienza's foundation model for aging reads the records the plan already holds and reports which cohorts carry the most expected cognitive change, counted, never named.

What the clinician keeps

Each result arrives with Proactive Decision Actions. Options, never orders. A care manager or clinician chooses the follow-up: a nurse call, a visit, a behavioral health referral, or nothing yet. The choice writes back to the EHR, dated and attributed.

Gia does not perform the plan's health risk assessment, does not document a condition and does not change a survey answer. Gia reaches the member and gives the team a reason to act. The AI co-clinician is clinical decision support, not a diagnosis. The follow-up record shows every attempt, every answer and every decision, which is what a measure built on follow-up asks for.

Where to start

Choose the members who screened positive for depression in the last quarter and the members in this year's Health Outcomes Survey sample. Have Gia check in with both groups now, and bring the ranked worklist to care management.

See how Medicare Advantage and D-SNP plans use Gia for follow-up that happens, then book a working session.