Medicare Advantage inclusion will reshape performance profiles.

Recent CMS updates to the Hospital Star Rating methodology make that clear. As we explored in our earlier analysis of changes to the Safety domain, CMS is continuing its shift toward measures that reflect real-world patient outcomes and safety performance. The latest change accelerates that direction—and expands who counts.

Beginning in 2027, CMS will include Medicare Advantage patients in key complication and mortality measures, starting with THA/TKA complications and stroke mortality. While the implementation date may feel distant, the data that will determine those future ratings is already being collected today.

For health systems with significant Medicare Advantage penetration, this is not a minor technical adjustment. It represents a meaningful expansion of the denominator—one that can materially alter performance profiles, peer benchmarks, and ultimately Star Ratings.

Importantly, CMS has already finalized much of the methodology and historical data underpinning this change. That means organizations that wait until inclusion goes live may be surprised by outcomes they’ve never fully evaluated.

Health system leaders should be asking:

• How does our Medicare Advantage population perform relative to traditional Medicare?
• Where will our complication and mortality outcomes shift once MA patients are included?
• Which service lines are most exposed to rating volatility?

Answering those questions requires visibility into the same Medicare Advantage data CMS will use to score performance.

Tendo has access to the Medicare Advantage data underpinning the THA/TKA complication and stroke mortality measures included in future Star Ratings. By analyzing this data alongside existing CMS measures, we help organizations model the impact of MA inclusion before it becomes official—identifying risk, pressure points, and opportunities for improvement.

As CMS continues to evolve the Star Ratings program, preparation is no longer about understanding the rules. It’s about understanding how your performance will look once those rules are applied.

Organizations that act now can replace uncertainty with insight—and position themselves to protect both performance and reputation as the methodology shifts.

See how Medicare Advantage inclusion could impact your Star Rating performance—and where to act now. Connect with Tendo to model the impact using the same data that CMS will apply.