Beyond the MTM Checkbox: Why MY 2027 Demands a Personal Approach to Adherence and Polypharmacy

Star Ratings are changing and medication management is at the center of them. As the Medicare population grows older and more clinically complex, medication regimens are harder to manage and monitor through one-time interventions. And those challenges aren’t abstract. They’re personal.

Many members take multiple medications each day, often prescribed by multiple providers, adjusted over time, and not always fully understood. What looks like non-adherence on paper is often something more complex: issues that aren’t visible in claims data alone.

Health plans have a clear role to play here. Prioritizing member safety and medication adherence ensures better health outcomes, which naturally strengthens Star Ratings performance and sustains the financial health needed to deliver high-quality care for years to come.

Plans that wait to adjust will be reacting, not preparing. Here’s how to refocus your strategy for 2027.

Address High-Risk Medication Combinations Head-On

For CY 2027, the following measures, which have been in the monitoring phase since MY 2025, will officially be integrated into the Star Ratings. These robust, outcome-driven measures target high-risk medication combinations to ensure:

• Concurrent Use of Opioids and Benzodiazepines (COB)
• Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH)

Medication safety requires minimizing the use of potentially dangerous combinations, especially those that may have compounding side effects. Opioids and benzodiazepines can multiply each other’s effects, which in severe cases can lead to overdose and death.

Untangling a regimen of 5, 8, or 10+ daily medications requires far more than a claims data algorithm. Polypharmacy causes real, personal harm to older adults, from severe cognitive impairment to devastating falls that threaten their independence.

Mitigating these risks requires ongoing, pharmacist-led support to identify the root cause, safely deprescribe when appropriate, and resolve unsafe interactions over time.

Strengthen Medication Adherence Where it Breaks Down

The medication adherence measures (diabetes, hypertension, and cholesterol) return to triple weighting for MY 2027 and remain core drivers of Star Ratings performance due to their impact on preventing costly acute care events.

But non-adherence is rarely just forgetfulness. It’s driven by personal, often complex barriers. For example, a patient may not be able to afford their copay, doesn’t fully understand their condition, or is contending with side effects that go unaddressed. Automated reminders and mailers can help, but they don’t solve these underlying issues.

To improve adherence, plans need to identify and address the underlying reasons a patient isn’t taking their medication as prescribed and resolve them in a way that is tailored to their individual needs.

Deliver on What MY 2027 Requires

It’s time to move beyond check-the-box MTM and adopt a more personalized approach to medication management.

Through Clarest Path, our clinical pharmacists provide an ongoing, individualized assessment of every medication. We don’t just “review” a profile once a year; we partner with the patient and their broader care team to optimize their entire medication regimen for appropriateness, safety, and adherence. We take a 360-degree view of the patient’s health story to identify the root causes of polypharmacy, non-adherence, and other treatment barriers, and we actively resolve them.

When care is centered on the person, not just the medication list, patients are more likely to stay safe, healthy, and independent.

Is your MY 2027 strategy aligned with CMS’s new clinical focus? Let’s connect to explore how Clarest Path can help drive better outcomes for your members.