Independent Practice Strategies Series

Authors: Ashley Williams, Will Williams
Date: April 9, 2026

Helping Patients Navigate 2027: The "Star Ratings" as Your Practice’s Secret Tool

As an independent provider in the Mid-South, you are often the first person a patient turns to when confused about their health insurance options. The individual market Open Enrollment Period (OEP) for the 2027 Plan Year begins on November 1, 2026, and your patients will soon be searching HealthCare.gov for the right coverage.

This recent CMS bulletin informs insurance Exchanges and Direct Enrollment (DE) entities and offers new opportunities for you and your patients to make informed decisions. Increased transparency can enhance your conversations with patients during plan selection.

The "Star Rating" as a Neutral Referral Tool

When a patient asks which plan to choose to continue seeing you, you generally cannot give financial or insurance advice. However, you can direct them to the Quality Rating System (QRS) Star Ratings.

CMS evaluates these plans on a 1-to-5 star scale based on three areas that directly reflect the quality of the healthcare ecosystem:

  • Medical Care: This rating reflects how well doctors coordinate care and achieve the best results for enrollees.
  • Member Experience: This is based on the QHP Enrollee Survey, measuring how patients rate their doctors and the care they receive.
  • Plan Administration: This covers plan management, affordability, and customer service.

Why Your Practice Should Understand the System

This is the most critical information for RHCs. State plans must commit to using the funds for at least three of the following ten activities:

  • A Resource for Patients: You can guide patients to the Marketplace, where CMS uses plain-language labels like "Overall Rating" and "Medical Care" to help them make informed choices.
  • Reputation Management: High ratings in "Medical Care" are the direct result of the hard work of independent practices and rural clinics.
  • Explaining "Not Rated" Plans: If a patient sees a plan labeled "New plan - Not Rated," you can clarify it hasn't been in operation long enough, typically less than 3 years, to receive a score.

Important Dates to Remember

  • October 2026: CMS will publish the final Quality Public Use Files (PUF).
  • November 1, 2026: The 2027 Open Enrollment Period begins, and 2026 ratings will be publicly displayed.

Free Download: Health Insurance Marketplace® Checklist

CMS provides a free checklist for your patients to get ready to apply for or re-enroll in Health Insurance Marketplace® Coverage. 

Download the Checklist Here

How Oasis Medical Solutions Can Help

We combine expertise in EHR optimization with an understanding of star rating metrics. Our solutions are tailored for independent practices and rural health clinics nationwide, and onsite implementation in Arkansas, Louisiana, Mississippi, Alabama, Oklahoma, and Texas, helping you capture accurate clinical outcomes and position your practice for higher national rankings and better patient engagement.

Learn more about how Oasis Medical Solutions provides a stable, all-in-one solution for independent practices and  Rural Health Clinics, or contact us today for a consultation.

Patient FAQ: Understanding Health Plan Star Ratings

Choosing a health insurance plan is an important decision. To help you compare options during the 2027 Open Enrollment Period, the Centers for Medicare & Medicaid Services (CMS) provides Quality Star Ratings for plans available through the Health Insurance Marketplace.

Consider these ratings a report card for insurance plans, showing how well each performs in areas important to your health.

What do the stars mean?

Plans are rated on a scale of 1 to 5 stars, with 5 being the highest quality.

  • Overall Rating: The plan’s general quality score.
  • Medical Care: How well the plan’s doctors coordinate care and achieve the best results for patients.
  • Member Experience: How other patients rate their doctors and the ease of getting the care they need.
  • Plan Administration: How well the plan manages its network, affordability, and customer service.

Frequently Asked Questions

You can find these ratings directly on HealthCare.gov or your state's health insurance exchange website starting November 1, 2026.

This does not mean the plan is of poor quality. It typically means the plan is new to the area and CMS does not yet have sufficient data to assign a score.

CMS calculates these scores using clinical data from health plans and results from the QHP Enrollee Survey, which asks patients about their real-life experiences with their doctors and care.

Yes! The "Medical Care" and "Member Experience" ratings are heavily influenced by the quality of care and coordination provided by your local healthcare team.

Important Disclaimer

Plan quality ratings and enrollee survey results are calculated by CMS in 2026 using data provided by health plans. The ratings are displayed for health plans for the 2027 plan year. For more information, visit HealthCare.gov.

We look forward to connecting with you online!

Oasis Medical Solutions is a trusted partner for healthcare practices, offering comprehensive services and support for Azalea Health's suite of electronic health record (EHR) and practice management solutions. Focusing on personalized implementation, training, and ongoing support, Oasis Medical Solutions helps clients optimize their technology to improve efficiency and deliver exceptional patient care.

Who is 
Oasis Medical Solutions

Oasis Medical Solutions is a healthcare technology company that helps medical practices streamline their operations and maximize revenue. We specialize in providing Electronic Health Records (EHR) systems and related services, including practice management software, billing solutions, and consulting.

With a focus on personalized service and customized solutions, Oasis aims to empower healthcare providers to navigate the complexities of the healthcare industry and focus on delivering quality patient care.

Value-added reseller on a client call, viewing Oasis website and EHR software on a split screen, assisting with healthcare technology solutions.

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