ALHC's flagship plan drops to 3.5 stars from 4.0; 2028 bonus payments at risk

Alignment's H3815 plan, covering 75% of its membership, fell from a 4.0-Star to 3.5-Star rating for 2027 due to higher CMS cut points and declines in certain quality measures. The company states this will impact quality bonus payments in fiscal 2028, though risk-sharing with providers will offset some impact and the company is pursuing mitigation strategies and administrative appeals.

Alignment's largest health plan lost one-half star in a quality rating, which will hurt its bonus payments next year but won't affect revenue until 2028. The company says it can recover the rating and reduce the financial hit.