With the release of CMS' Final Rate Announcement last week, we saw the largest rate increase in a decade for Medicare Advantage (MA) health plans. MA plans will see an average increase of 5.06% which will result in more than $25B in additional payments in 2026. This payment increase will help combat rising costs, and plans can also reinvest the extra funds in their benefit offerings to remain competitive.
At Nymbl, we stay on top of the evolving MA landscape. While our core focus is driving significant medical cost savings for our MA partners, we actively monitor Star Ratings to understand how they impact our MA plans. As such, we're sharing the 3 top strategies you can implement for success.
The 2026 MA payment increase is welcome, but don’t forget that the driver of this historic rate increase is due to rising healthcare utilization and inflation. Need to find a quick way to optimize medical cost savings? Falls alone cost Medicare $30B annually - more per member, per month (PMPM) than most chronic conditions. A population-wide fall prevention program is an unoptimized opportunity to improve MLR and margins. Nymbl offers a clinically validated, digital solution that reduces fall risk, reduces fear, and avoids claims - without burdening providers. Preventative care to scale, with a 30-day speed to market and guaranteed 3:1 ROI within 12 months is one of the few ways to reduce cost without cutting member benefits. In fact, Nymbl’s medical cost savings can be leveraged in the bid to make room for additional benefits that make a plan more competitive.
During an interview with Nymbl, Stars healthcare expert Jessica Muratore (Muratore Advisory Services) noted:
Jessica is right - HOS has a significant impact on how plans perform on Star Ratings and these are the lowest performing measures! Plans must act now to take advantage of this opportunity to improve these hard-to-move measures. How? Well, 72% of the members using Nymbl’s digital balance training reported having a discussion about their fall risk with their PCP. The “Reducing Risk of Falling” measure is the lowest performing in all of Star Ratings (2025), thus a significant improvement opportunity, competitive benefit, and target for medical cost savings.
We saw in the 2026 Final Rule (which released on April 4th), that CMS continues to prioritize member experience and protections through tightening rules around appeals, prior authorization, and D-SNP integration. All of these changes will have an impact on a plan’s Star Ratings, most notably through the CAHPS. Nymbl’s fall prevention is proven to garner high member enrollment and ongoing engagement - improving plan satisfaction, retention, and improved health outcomes (with 62% showing meaningful balance improvement). Better experience = better CAHPS performance. Nymbl members report a 48% increased likelihood of renewing their current plan and a 62% improved satisfaction rate with their plan as a result of using Nymbl.
Nymbl helps MA plans drive improvements in cost, quality, and member experience - across general populations, including members with mobility risks, low engagement, or social complexity.
If significantly reducing medical costs is a priority for you in 2025 and beyond (with the added benefit of helping improve Star Ratings), let’s talk.
SVP of Sales
jeff.voss@nymblscience.com