Cut points are the thresholds CMS sets each year to turn a measure's score into a 1 to 5 star rating. Because CMS sets them from the distribution of every contract's score, no plan knows the exact cut point in advance, so quality teams plan to a margin. This cheat sheet is free to print or save as a PDF, no email required.
How CMS sets cut points
The mechanics, in four steps
- Collect the field. CMS takes every contract's score for a measure.
- Remove outliers (Tukey). For non-CAHPS measures, CMS deletes scores outside 3.0 times the interquartile range below the first quartile or above the third quartile.
- Cluster. A clustering algorithm groups the remaining scores into five bands, which become the 1 to 5 star thresholds.
- Apply the guardrail. A cut point cannot move more than 5 percentage points from the prior year for most non-CAHPS measures.
The terms on one page
| Term | What it means |
|---|---|
| Cut point | The score threshold that earns a given star level for a measure. |
| Tukey outlier deletion | Removes extreme outlier contract scores (3.0x IQR fences) before clustering, which stabilizes cut points year to year. |
| Guardrail | Caps year-over-year cut-point movement at 5 percentage points for most non-CAHPS measures. |
| Reward Factor | An adjustment of up to 0.4 added for consistently high performance with low variance. Applies for the 2026 Star Year. |
| EHO4all (2027) | The Excellent Health Outcomes for All adjustment, previously the Health Equity Index, replaces the Reward Factor starting Star Year 2027 and phases in at a smaller initial value. |
For the 2026 Star Year detail, see the 2026 Star Ratings cut points explainer; for what changes next year, see the 2027 Star Ratings changes.
Glide-path planning worksheet
List your priority measures, last year's 4-star cut point, your current rate, and the gap to close. Add the 5-point guardrail to last year's cut point to set a safe target, since the real cut point can move up that far.
| Measure | Weight | Prior 4-star cut point | Your current rate | Gap to target |
|---|---|---|---|---|
Prioritize the triple-weighted measures first, since a few points there move the summary rating more than almost any other lever.
How Pelica helps you hit the cut point
The hard part is not knowing the cut point. It is closing enough gaps, on the right members, before the measurement year ends. Most platforms show the gap list. Pelica's Quality and Stars copilot forecasts the glide path to each cut point, flags the members who can still move the measure, and closes the loop from outreach to a sourced, scorable result. Across deployments, customers close about 90% of BCS and KED gaps in-year and 70% or more of transitions-of-care gaps within 30 days.