Credit: © SUMALI IBNU CHAMID via Canva.com Perficient has launched an AI suite to help Medicare Advantage plans raise their CMS star ratings, which decide access to more than $13B a year in federal bonus payments. It arrived a day after CMS published 2027 ratings showing fewer plans qualifying, and the consultancy is owned by Swedish buyout group EQT. Perficient has launched AI tools to help Medicare Advantage plans raise their federal star ratings. They arrived a day after CMS published ratings showing fewer plans qualifying for bonus money.
The consultancy says the tools use predictive analytics, simulation modelling and what it calls agent-driven engagement, according to its announcement. No customer, price or result was disclosed. Federal spending on the Medicare Advantage quality bonus programme reached at least $13.4B in 2026, about 2.3% of projected payments to the programme, according to KFF. Plans rated four stars or better out of five get a higher spending benchmark, typically by five percentage points.
Those above 4.5 stars keep 70% of the gap between benchmark and bid. Qualifying is getting harder. CMS published the 2027 ratings on 8 October, and 188 of 508 rated contracts reached four stars or more, against 229 of 516 a year earlier. The share of members in bonus-eligible plans had already dropped to 68% in 2026 from 75%, the lowest since 2018.
Five-star contracts fell from 22 to 15. What the ratings measure is contested. MedPAC, which advises Congress on Medicare, argues they use too many measures, fail to account for social risk and are reported at contract rather than plan level. So the software targets a number the government’s own advisers call a weak proxy for care.
The Congressional Budget Office estimated in 2018 that scrapping the programme would save almost $100B over a decade. The owner is European. EQT, the Swedish group that manages about €130B and was in talks with Alphabet over model licensing for its portfolio, bought Perficient for roughly $3B and delisted it in October 2024. Perficient employs about 7,000 people and runs European delivery hubs in Romania, Serbia and the United Kingdom.
Washington is pointing AI at the same programme from the other end. HHS began screening claims for fraud before payment in May, covering Medicare, Medicaid and the insurance marketplace. The ratings are also in court. Clover Health won a recalculation of the 2026 scores, which KFF estimates adds about $600M to 2027 payments, and CMS appealed that decision in July.
Humana sued after one large contract dropped from 4.5 stars to 3.5, and courts have sided with CMS so far. Litigation and now software are routes to the same half-star.
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