What Is Star Year 2026 CAHPS Data Really Telling Medicare Advantage Plans?

The First Plan Preview Period for the 2026 Star Year runs now through August 13th, giving Medicare Advantage plans just days to challenge their CAHPS data before final scoring. While plans focus on their individual contract reviews, CMS has simultaneously released publicly available CAHPS cut points, national averages, and state-by-state performance data. Pareto Intelligence has analyzed this public data to identify insights for Medicare Advantage plans. Our analysis reveals a mixed bag of industry performance and YoY cut point changes. Patient experience measures, such as Getting Needed Care and Care Coordination are rebounding from pandemic lows, while Annual Flu Vaccine and Rating of the Health Plan performance dropped. Perhaps most striking are the dramatic geographic CAHPS performance differences we identified—variations that should impact how plans approach market planning and goal setting. This analysis examines these trends and their implications for health plans, as they dissect their newly released CAHPS results.

What We Know About the 2026 CAHPS Data Release

• The First Plan Preview for the 2026 Star Year runs August 6-13. During this period, health plans can review data for all Star measures that CMS intends to use in scoring each Medicare contract and challenge any anomalies it perceives. This data is only made available to plans directly.
• As a part of this release, plans also receive their official CAHPS results, inclusive of case-mix adjusted scores, and final Stars for the 9 CAHPS measures
• In parallel, CMS also releases publicly the CAHPS cut points, as well as state- and nation-wide unadjusted average scores.

What Are We Seeing in the Public Medicare Advantage Data?

National Trends

• In aggregate, MAPD CAHPS cut points for the 2-weighted measures were up slightly YoY
  • Measures showing the largest increases were those related to patient experience—Getting Needed Care, Care Coordination, and Rating of Health Care Quality
  • Notable exception to the trend was the 1-wt Flu Vaccine measure, which continued its 4-year decline
  • Two of the Rating of the Health Plan (2 weight) cut points declined 1 point
• National Average Measure score performance mirrored trends in the cut points, with 5 of the 9 CAHPS measures showing YoY increases (all <1%), 3 measures declining <1%, and the Annual Flu Vaccine measure declining 2.1% YoY

Regional Insights

• Performance by State varies widely
  • The beneficiaries who respond most favorably to the CAHPS survey live in the Midwest, Mid Atlantic and Southeast Regions of the US (LA, NC, PA with highest aggregate scores)
  • Beneficiaries in the western US rate the survey least favorably (NM, AZ, OR, WA especially)
  • The northeast has a mix of strong states (VT, RI) and lower scoring (ME, CT)
• Regional performance differences are likely due to differences in local market dynamics (provider network, member demographics, county benchmarks driving product makeup), more than plan-specific management.
  • Measures of patient experience (e.g., Getting Needed Care) tend to have higher state-to-state variation than measures more reflective of a beneficiary’s assessment of the Health plan (e.g., Rating of Drug Plan, Customer Service)
  • Nearly all states have large multi-state, national plans maintaining significant market share, indicating that centralized plan management is likely not the driver of regional difference in performance.

YoY Cut Point Change Summary

Analysis

• CAHPS cut points maintained relative YoY stability, with 58% of cut points remaining the same YoY
• More measures increased than decreased, driven by measures of the patient experience (e.g., Care coordination, Getting Needed Care)
• Annual Flu Vaccine saw 3-4% decreases in cut points (larger than the drop in the national average drop of ~2%)
• Rating of the Health Plan was the only 2 wt measure that saw decreasing cut points, with 2 of them decreasing 1% each YoY

YoY Trend Summary of National Benchmark CAHPS Measure Performance

State By State Performance Summary

Our Approach

• Pareto Intelligence analyzed publicly available data on state-wide CAHPS averages, and CAHPS cut points to calculate hypothetical state-wide base groups for each CAHPS measure, and a weighted CAHPS composite.
• Full analysis available for download below

Our Summary Insights

• CAHPS results are the highest in the Midwest, Mid Atlantic, and Southeastern US
  • Louisiana, North Carolina, and Pennsylvania score the highest in the country in the analysis
  • Outside these regions, only PR, VT, and RI were in the top half of performing states

• Western states, particularly in the Southwest (NM, AZ), and Northwest (OR, WA) scored the worst
  • In aggregate, these states perform worst in Patient Experience measures (Care Coordination, Getting Appointments and Care Quickly, Getting Needed Care); other CAHPS measures show performance closer to those of other states.

• Patient Experience measures show the highest state-to-state variance in cut-point-adjusted performance, possibly indicating diverging national views of beneficiaries’ local provider networks

• The Customer Service measure shows very low levels of variation by state. When taken with the very consistent yearly cut points, this is likely an indication of difficulty for plans to make meaningful actions to change performance in this measure.

Analysis: Hypothetical CAHPS Base Group Composite, by State

So What? Now What?

Insight

Performance varies widely by state, likely even within the same carriers

Implication

• Healthcare is local, and winning requires local solutions
• Plans should invest in understanding localized CAHPS performance (e.g., through Mock Surveys), and use that as an input to market planning (e.g., entering / exiting specific markets)
• Plans should set CAHPS goals that are informed by geographic performance norms (i.e., don’t set unrealistic targets if you operate primarily in a challenging state), and balance out contract goals with other clinical and operational Star measures.

Insights

Measures of the patient experience have wider state-to-state variance than those that reflect Plan perception

Patient Experience measures are rebounding from their pandemic lows, close to, or exceeding pre-COVID levels

Implication

• The provider network plays a differentiating role in a plan’s CAHPS performance, and plans that are doing well are likely seeing the results of investments made in recent years.
• Access and Availability of care should be taken into consideration, in addition to cost of care and member perception when designing and incentivizing MA networks.
• Partnering with providers to promote clinical data exchange and interoperability should be seen as important to driving CAHPS performance.

Insight

Publicly available CAHPS data provide an opportunity to validate the CAHPS data they received this week

Implication

• Plans should make direct requests to CMS for detailed CAHPS files, including case mix adjustment details (CMS typically will not provide it without request)
• Plans should verify that all calculations have been performed correctly, including aspects of the “deep CAHPS math” (national average delta, reliability, distance above / below 80^th / 15^th percentile, etc.)

Access the Complete Analysis

This preliminary analysis provides the foundation, but the complete picture requires deeper investigation. Our full report includes comprehensive state-by-state performance breakdowns, detailed cut-point analysis for all CAHPS measures, and strategic recommendations tailored to specific geographic markets. The complete analysis examines performance patterns within individual states, identifies market-specific opportunities for improvement, and provides actionable insights for data validation during the remaining preview period.

For Medicare Advantage plans serious about maximizing their Star Rating performance and understanding their competitive position, the complete CAHPS analysis is essential reading. The geographic intelligence contained in the full report could determine whether your organization sets realistic, achievable goals or chases impossible targets in challenging markets.

Complete the form below to access the full CAHPS Preliminary Analysis with comprehensive state-by-state data and strategic recommendations.

To learn how Pareto can support your Stars strategy, get in touch at contact@paretointel.com.