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You cannot control CMS raising cut points. But you can control how you respond.
Changes are happening to how Medicare Advantage plans are measured for medication adherence. Starting in measurement year 2026, CMS is introducing sociodemographic status (SDS) risk adjustment into the three Part D adherence measures: diabetes medications, RAS antagonists, and statins.
What’s Actually Changing
SDS risk adjustment recognizes a simple truth that we’ve long understood. Not all members face the same barriers to taking their medications consistently.
Starting in this measurement year, your adherence scores will account for factors that significantly impact medication-taking behavior. These include age, gender, disability status, and whether members qualify for low-income subsidy or dual eligibility (LIS/DE).
Here’s when these changes take effect.
- In measurement year 2026 (for 2028 Star Ratings): SDS-adjusted adherence measures officially enter the Star Ratings with 1x weighting.
- In measurement year 2027 (for 2029 Star Ratings): SDS-adjusted adherence measures return to 3x weighting.