Datasets:

tensorust
/

ma-stars-bonus-cliff-sample

contract stringlengths 5 5	contract_name stringlengths 17 50	marketing_name stringlengths 6 49	parent_org stringlengths 10 40	org_type stringclasses 1 value	segment stringclasses 1 value	qbp_rating_basis stringclasses 1 value	qbp_rating_2026 float64 4 4.5	qbp_rating_2027 float64 2.5 3.5	rederived_raw_score_2027 float64 2.71 3.65	raw_points_short_of_4_0 float64 0.1 1.04	reward_factor float64 0 0.1	cai float64 -0.07 0.11	enrollment_oct_2026 int64 38.8k 411k	qbp_benchmark_dollars_lost_2028 float64 45.4M 353M	est_rebate_dollars_lost_2028 float64 29.5M 315M	annual_bonus_value_at_4_stars float64 40M 353M	projected_2028_rating_same_performance float64 2.5 3.5	measures_scored int64 28 36	closest_measure_distance_2027 float64 -2 1	rederivation_check stringclasses 1 value	parent_contracts int64 2 64	parent_dollars_lost_2028 float64 -2,755,546,166 997M	parent_enrollment int64 56.3k 9.32M	parent_ontology_oid stringclasses 9 values	source stringclasses 1 value
H4513	HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.	HealthSpring	Health Care Service Corporation	Local CCP	LOST BONUS	Overall	4.5	3.5	3.4453	0.3047	0	0.008676	387,988	353,265,234	314,865,877	353,189,519	3.5	36	0	re-derived rating matches CMS	22	341,660,613	875,171	org:HEALTH CARE SERVICE	https://www.cms.gov/medicare/health-drug-plans/part-c-d-performance-data
H3359	HEALTHFIRST HEALTH PLAN, INC.	Healthfirst Medicare Plan	Healthfirst, Inc.	Local CCP	LOST BONUS	Overall	4.5	3.5	3.4826	0.2674	0	0.042618	359,161	327,058,364	297,331,884	327,058,364	3.5	32	0	re-derived rating matches CMS	4	327,058,364	374,633	org:HEALTHFIRST	https://www.cms.gov/medicare/health-drug-plans/part-c-d-performance-data
H2802	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	UnitedHealth Group, Inc.	Local CCP	LOST BONUS	Overall	4	3.5	3.5083	0.2417	0	-0.01025	411,301	324,889,356	211,178,082	324,889,356	3.5	34	0.06	re-derived rating matches CMS	64	997,397,066	9,315,887	org:UNITEDHEALTH GROUP	https://www.cms.gov/medicare/health-drug-plans/part-c-d-performance-data
H0543	UHC OF CALIFORNIA	UnitedHealthcare	UnitedHealth Group, Inc.	Local CCP	LOST BONUS	Overall	4	3	3.2107	0.5393	0	-0.036054	249,748	219,965,777	277,672,225	213,656,592	3	33	0.16	re-derived rating matches CMS	64	997,397,066	9,315,887	org:UNITEDHEALTH GROUP	https://www.cms.gov/medicare/health-drug-plans/part-c-d-performance-data
H3959	AETNA HEALTH INC. (PA)	Aetna Medicare	CVS Health Corporation	Local CCP	LOST BONUS	Overall	4	3.5	3.4747	0.2753	0	0.042618	205,661	206,927,894	134,740,434	206,927,894	3.5	36	0	re-derived rating matches CMS	43	560,483,485	4,175,687	org:CVS HEALTH	https://www.cms.gov/medicare/health-drug-plans/part-c-d-performance-data
H3815	ALIGNMENT HEALTH PLAN	Alignment Health Plan	Alignment Healthcare USA, LLC	Local CCP	LOST BONUS	Overall	4	3.5	3.3687	0.3813	0	0.008676	225,609	187,040,403	121,642,466	187,040,403	3.5	32	-1	re-derived rating matches CMS	9	186,883,547	301,157	null	https://www.cms.gov/medicare/health-drug-plans/part-c-d-performance-data
H1889	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	UnitedHealthcare	UnitedHealth Group, Inc.	Local CCP	LOST BONUS	Overall	4	3.5	3.2732	0.4768	0	0.075637	265,678	169,434,560	110,132,464	169,434,560	3	35	-1	re-derived rating matches CMS	64	997,397,066	9,315,887	org:UNITEDHEALTH GROUP	https://www.cms.gov/medicare/health-drug-plans/part-c-d-performance-data
H3655	COMMUNITY INSURANCE COMPANY	Anthem Blue Cross and Blue Shield	Elevance Health, Inc.	Local CCP	LOST BONUS	Overall	4	3.5	3.2718	0.4782	0	-0.01025	143,167	163,482,773	106,289,170	163,482,773	3	34	0	re-derived rating matches CMS	42	108,172,153	1,889,475	org:ELEVANCE HEALTH	https://www.cms.gov/medicare/health-drug-plans/part-c-d-performance-data
H7917	BLUECROSS BLUESHIELD OF TENNESSEE, INC.	BlueCross BlueShield of Tennessee	BlueCross BlueShield of Tennessee	Local CCP	LOST BONUS	Overall	4	3.5	3.4511	0.2989	0	-0.036054	189,059	160,501,025	105,111,355	160,501,025	3.5	30	-2	re-derived rating matches CMS	2	160,501,025	220,412	org:BLUECROSS BLUESHIELD OF TENNESSEE	https://www.cms.gov/medicare/health-drug-plans/part-c-d-performance-data
H5322	CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.	UnitedHealthcare	UnitedHealth Group, Inc.	Local CCP	LOST BONUS	Overall	4	3.5	3.4213	0.3287	0	0.075637	218,576	148,001,153	96,200,750	148,001,153	3.5	34	0	re-derived rating matches CMS	64	997,397,066	9,315,887	org:UNITEDHEALTH GROUP	https://www.cms.gov/medicare/health-drug-plans/part-c-d-performance-data
H0628	AETNA HEALTH OF OHIO INC.	Aetna Medicare	CVS Health Corporation	Local CCP	LOST BONUS	Overall	4	3.5	3.4994	0.2506	0	0.042618	134,684	123,617,052	80,351,084	123,617,052	3.5	36	-1	re-derived rating matches CMS	43	560,483,485	4,175,687	org:CVS HEALTH	https://www.cms.gov/medicare/health-drug-plans/part-c-d-performance-data
H1961	PEOPLES HEALTH, INC.	Peoples Health	UnitedHealth Group, Inc.	Local CCP	LOST BONUS	Overall	4.5	3.5	3.376	0.374	0	0.042618	157,054	120,255,660	111,571,167	119,904,478	3.5	32	-1	re-derived rating matches CMS	64	997,397,066	9,315,887	org:UNITEDHEALTH GROUP	https://www.cms.gov/medicare/health-drug-plans/part-c-d-performance-data
H2663	COVENTRY HEALTH CARE OF MISSOURI, INC.	Aetna Medicare	CVS Health Corporation	Local CCP	LOST BONUS	Overall	4	3.5	3.3359	0.4141	0	-0.01025	115,285	107,379,082	69,796,403	107,379,082	3.5	35	0.04	re-derived rating matches CMS	43	560,483,485	4,175,687	org:CVS HEALTH	https://www.cms.gov/medicare/health-drug-plans/part-c-d-performance-data
H4152	BLUE CROSS & BLUE SHIELD OF RHODE ISLAND	Blue Cross & Blue Shield of Rhode Island	Blue Cross & Blue Shield of Rhode Island	Local CCP	LOST BONUS	Overall	4	3.5	3.322	0.428	0	-0.036054	74,402	91,456,279	60,534,573	91,456,279	3.5	32	1	re-derived rating matches CMS	2	91,909,952	76,863	null	https://www.cms.gov/medicare/health-drug-plans/part-c-d-performance-data
H4141	HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.	Humana	Humana Inc.	Local CCP	LOST BONUS	Overall	4	3.5	3.5867	0.1633	0	0.042618	125,352	82,171,922	53,411,749	82,171,922	3.5	31	0	re-derived rating matches CMS	39	-2,755,546,166	7,193,062	org:HUMANA	https://www.cms.gov/medicare/health-drug-plans/part-c-d-performance-data
H3388	CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.	CDPHP Medicare Advantage	Lifetime Healthcare, Inc.	Local CCP	LOST BONUS	Overall	4.5	3.5	3.3614	0.3886	0	-0.036054	69,849	75,409,007	67,649,395	73,206,642	3	29	0	re-derived rating matches CMS	5	76,096,656	335,053	null	https://www.cms.gov/medicare/health-drug-plans/part-c-d-performance-data
H2293	SILVERSCRIPT INSURANCE COMPANY	Aetna Medicare	CVS Health Corporation	Local CCP	LOST BONUS	Overall	4	3.5	3.382	0.368	0	0.008676	115,246	74,979,573	48,736,723	74,979,573	3	35	0	re-derived rating matches CMS	43	560,483,485	4,175,687	org:CVS HEALTH	https://www.cms.gov/medicare/health-drug-plans/part-c-d-performance-data
H6723	MEDICAL MUTUAL OF OHIO	Medical Mutual of Ohio	MEDICAL MUTUAL OF OHIO	Local CCP	LOST BONUS	Overall	4	3.5	3.6522	0.0978	0.1	-0.036054	60,935	72,710,208	47,456,663	72,710,208	3.5	31	0	re-derived rating matches CMS	2	72,710,208	73,204	null	https://www.cms.gov/medicare/health-drug-plans/part-c-d-performance-data
H0169	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	UnitedHealth Group, Inc.	Local CCP	LOST BONUS	Overall	4	3.5	3.4416	0.3084	0	0.108248	102,068	66,632,812	43,311,328	66,632,812	3.5	34	0.1	re-derived rating matches CMS	64	997,397,066	9,315,887	org:UNITEDHEALTH GROUP	https://www.cms.gov/medicare/health-drug-plans/part-c-d-performance-data
H3668	MOUNT CARMEL HEALTH PLAN, INC.	MediGold	Trinity Health Corporation	Local CCP	LOST BONUS	Overall	4.5	3.5	3.456	0.294	0	-0.069659	58,586	64,228,282	54,848,429	64,161,533	3.5	28	1	re-derived rating matches CMS	4	79,390,007	78,170	org:TRINITY HEALTH #KCBGNFJGK478	https://www.cms.gov/medicare/health-drug-plans/part-c-d-performance-data
H3794	UNITEDHEALTHCARE OF WISCONSIN, INC.	UnitedHealthcare	UnitedHealth Group, Inc.	Local CCP	LOST BONUS	Overall	4	3.5	3.4816	0.2684	0	0.108248	47,354	47,387,559	30,801,913	47,387,559	3.5	35	0	re-derived rating matches CMS	64	997,397,066	9,315,887	org:UNITEDHEALTH GROUP	https://www.cms.gov/medicare/health-drug-plans/part-c-d-performance-data
H6396	CARESOURCE OHIO, INC.	CareSource MyCare Ohio (HMO D-SNP)	CareSource	Local CCP	LOST BONUS	Overall	4.5	3.5	3.437	0.313	0	0.108248	38,781	45,534,947	38,390,107	45,534,947	3	32	-1	re-derived rating matches CMS	5	45,534,947	85,120	org:CARESOURCE	https://www.cms.gov/medicare/health-drug-plans/part-c-d-performance-data
H7379	CAREFIRST ADVANTAGE PPO, INC.	CareFirst BlueCross BlueShield Medicare Advantage	CareFirst, Inc.	Local CCP	LOST BONUS	Overall	4	2.5	2.7075	1.0425	0	-0.036054	47,606	45,502,927	54,699,313	39,968,791	2.5	34	0.07	re-derived rating matches CMS	2	45,502,927	56,297	null	https://www.cms.gov/medicare/health-drug-plans/part-c-d-performance-data
H5932	GATEWAY HEALTH PLAN, INC.	Highmark Wholecare Medicare Assured	Highmark Health	Local CCP	LOST BONUS	Overall	4	3.5	3.3482	0.4018	0	0.108248	40,593	45,458,166	29,547,808	45,458,166	3.5	34	-1	re-derived rating matches CMS	9	48,679,280	424,853	null	https://www.cms.gov/medicare/health-drug-plans/part-c-d-performance-data
H0432	UNITEDHEALTHCARE OF THE MIDLANDS, INC.	UnitedHealthcare	UnitedHealth Group, Inc.	Local CCP	LOST BONUS	Overall	4	3.5	3.3156	0.4344	0	0.075637	55,308	45,449,575	29,542,224	45,449,575	3.5	31	0	re-derived rating matches CMS	64	997,397,066	9,315,887	org:UNITEDHEALTH GROUP	https://www.cms.gov/medicare/health-drug-plans/part-c-d-performance-data

Medicare Advantage Star Bonus Cliff 2028: free sample (Tensorust LLC)

Every MA contract's 2028 quality bonus won, lost or at stake at the 4-star line.

Headline: 72 Medicare Advantage contracts dropped below 4 stars in the 2027 Star Ratings and lose about $4.15B of 2028 quality bonus benchmark dollars.

This repository is a free teaser, not the dataset. It holds 25 example rows and a summary table with no names in it. The full file has 681 rows and is sold by Tensorust LLC: https://tensorust.com/datasets/ma-stars-bonus-cliff/.

Files here

file	what it is
`sample.csv`	25 rows of the full file (the same sample shown on tensorust.com)
`summary_by_segment.csv`	row counts and totals by segment across the full file, no entity names (groups with fewer than 3 rows are folded into "Other")

Summary by segment (largest groups)

Segment	rows	Enrollment Oct 2026
(blank)	396	15,655,000
AT 4.0 EDGE	108	12,549,695
AT 3.5	105	2,404,575
LOST BONUS	72	4,929,700
TOTAL	681	35,538,970

Full table: summary_by_segment.csv.

What the full file has

681 rows
Key fields: contract, contract_name, marketing_name, parent_org, org_type, segment, qbp_rating_basis, qbp_rating_2026, qbp_rating_2027, rederived_raw_score_2027
Parquet and CSV, a README with sources, method and limits, and the build script
Free 25-row sample (no personal contact data)

Coverage: 681 MA contracts in scope (508 rated), all parents. 2027 Star Ratings (released Oct 2026); built Nov 6 2026

Columns in the full file

column	meaning
`contract`	CMS contract id
`contract_name`	Legal entity
`marketing_name`	Marketing name
`parent_org`	Parent organization
`org_type`	Organization type
`segment`	LOST BONUS, AT 3.5, AT 4.0 and similar watch segments
`qbp_rating_basis`	Rating used for QBP
`qbp_rating_2026`	2026 QBP rating
`qbp_rating_2027`	2027 QBP rating
`rederived_raw_score_2027`	Tensorust re-derived raw summary score
`raw_points_short_of_4_0`	Raw points short of the 3.75 rounding line for 4.0
`reward_factor`	Reward factor
`cai`	Categorical adjustment index
`enrollment_oct_2026`	Enrollment, Oct 2026
`qbp_benchmark_dollars_lost_2028`	2028 QBP benchmark dollars lost
`est_rebate_dollars_lost_2028`	Estimated 2028 rebate dollars lost
`annual_bonus_value_at_4_stars`	Annual bonus value at 4 stars
`projected_2028_rating_same_performance`	Projected 2028 rating at the same scores under projected cut points
`measures_scored`	Measures with a distance to the next star
`closest_measure_distance_2027`	Smallest distance to the next cut point among its measures
`rederivation_check`	Re-derived rating vs CMS
`parent_contracts`	Parent's contracts in scope
`parent_dollars_lost_2028`	Parent total 2028 dollars lost
`parent_enrollment`	Parent enrollment in scope
`parent_ontology_oid`	Tensorust ontology organization id (name match)
`source`	CMS Part C and D performance data page

Get the full file

tier	price	includes
Contract file	from $4,500	Every contract of one parent: 2028 bonus dollars lost or at stake by county, the re-derived 2027 rating, the measures closest to the next cut point under 2027 and projected 2028 cut points, and the path back to 4.0. $4,500 (under $1M lost), $7,500, $14,500, $19,500, $24,500 ($100M and up).
Contract file with updates	from $7,500	The contract file re-run when CMS posts corrections, when the 2028 Rate Announcement and ratebook land (April 2027) and at the first 2028 plan preview (about August 2027). $7,500 to $39,500 by band.
Full market dataset	from $25,000 a year	All 681 MA contracts in scope with measure-level distances to the 2027 and projected 2028 cut points (21,822 measure rows), re-derived scores and bonus dollars at stake. $25,000 to $45,000 a year by the buyer's size.

Email mattbusel@tensorust.com with the tier and a billing contact, and we will send a proper invoice (ACH or card). The file is delivered once the invoice is paid. Details and the live sample: https://tensorust.com/datasets/ma-stars-bonus-cliff/. All datasets: https://tensorust.com/datasets/

Method and limits

Re-derive each contract's 2027 summary rating from measure stars, weights, reward factor and CAI, compare with the QBP threshold, apply 2028 bonus percentages to county benchmarks weighted by enrollment, project 2028 cut points from the 2026 to 2027 trend within the guardrail, roll up per parent.

Not CMS's 2028 rating (not published until Oct 2027), not an appeal or rating challenge, no clinical or coding advice, no contact data. 2028 cut points are projections.

Sources

CMS 2026 and 2027 Part C and D Star Ratings data and Technical Notes
CMS MA enrollment by contract, Oct 2026; CMS 2027 ratebook
42 CFR 422.258(d) and 422.166 (QBP and Star Ratings methodology)

License

The sample and summary here are free to view, analyze and cite with attribution to "Tensorust LLC, https://tensorust.com/datasets/ma-stars-bonus-cliff/". The full dataset is licensed separately per tier. No resale or redistribution of Tensorust data without a written license.

Tensorust LLC, Tuckahoe NY. mattbusel@tensorust.com | https://tensorust.com

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Total file size:

17.9 kB