From display to prime time: What the new physical and mental health measures mean for MA plans
The 2026 Star Ratings include two new measures derived from the Health Outcomes Survey (HOS) — Improving or Maintaining Physical Health and Improving or Maintaining Mental Health. These measures will each have a weight of 1 for the 2026 Star Ratings and a weight of 3 beginning with the 2027 Star Ratings, representing a concerted effort from CMS to elevate whole-person health within the Medicare Advantage program.
The increased weighting beginning in MY 2027 also signals a renewed emphasis on longitudinal care. HOS surveys operate on a two-year timeframe and rely on self-reported health outcomes from members. For plans to perform well on these new measures — and all 5 Stars measures derived from the HOS — long-term engagement is critical.
“Older adults face numerous barriers to staying active — pain limitations, time constraints, lack of motivation, and uncertainty about what movements can help or hurt,” says Chris Lloyd, Director of Product. “Bold’s programs are designed to break down those barriers, focusing on habit formation. When members engage with Bold, they don’t just move more — they feel more confident in their ability to manage their health, which is key to improving HOS outcomes.”
Improving or maintaining physical health: Focus on the functional
The Improving or maintaining physical health measure is made up of questions that speak to members’ ability to accomplish daily activities, like household chores, climbing stairs, and even bowling, without limitations from pain or otherwise limited mobility. The measure differs from Monitoring physical activity in its focus on overall functionality and individual agency.
Pain increases with age: both chronic and high-impact pain are most prevalent for those 65 and older. CMS surveys have found that up to three-quarters of Medicare enrollees suffer from chronic pain and that women suffer at greater rates than men. In Bold’s previous research, we have found that pain is a common barrier to exercise, which can help alleviate symptoms, because members often have concerns over what movements are safe to do.
Addressing members’ physical health as part of your HOS strategy requires a focus on functionality and agency: promoting activities and solutions that enable members to live life unencumbered. When positioning resources to members, it is important to emphasize the real-life, tangible benefits they offer. At the same time, to maximize engagement, it’s critical to show that your solutions work for those of all ability levels, not just those who are already physically active. Solutions that are personalized and address members’ functional limitations, like Bold, are well-suited to advance performance on this particular measure.
Data reporting shows members who engaged with Bold for three months or longer are 69% more likely to report their physical health has improved compared to the previous year than those who participated for one month or less.
Improving or maintaining mental health: The mind-body connection
The Improving or maintaining mental health measure is based on members reporting feelings of depression, anxiety, loneliness, isolation, and fatigue.
As with all of the HOS-derived Stars measures, ‘mental health’ relies on members’ self-perceptions. In studies, there is a correlation between age and worsening self-perceptions of health. Specifically, members who report higher rates of depression and anxiety tend to report worse health overall.
When it comes to supporting members’ mental health, lifestyle interventions including exercise demonstrate powerful effects. Exercise can help individuals feel greater agency through building strength, balance, and endurance. And while exercise is notorious for low adherence, digital exercise solutions that incorporate behavior-change tools can generate lasting impact.
How Bold helps: Empowering daily progress across mental and physical health
Historically, MA plans have relied on just-in-time interventions to try and influence HOS performance. Reminders, check-ins, updates, and follow-ups all have their place — but these isolated touchpoints alone can’t actually alter member well-being. To help members feel like they are improving across both physical and mental health, Bold has adopted a set of simple tools customized to each member, centered on the simple concept of a daily checklist.
It’s called Today’s Plan; a dedicated space for personalized exercise and movement recommendations, paired with educational resources from Bold’s experts in healthy aging. The checklist reinforces member accomplishments — such as workout streaks and classes completed — to foster a sense of achievement and encourage ongoing engagement.
This dynamic approach is especially critical in a landscape where less than 15 percent of older adults achieve the recommended physical activity levels— even though over 95 percent of plans offer some form of fitness benefit. With Bold, members average more than 4 education and exercise encounters every week.
“We aren’t going to feel our best every single day, and that’s OK,” says Lloyd. “We are always looking for ways to help members feel a sense of positive momentum — whether it be engaging with movement or educational content — and we know that’s a big reason why they keep coming back.”
Ready to learn more about movement as medicine? Get in touch or visit agebold.com/partnerships.