Perficient has launched a new suite of artificial intelligence tools designed to help Medicare Advantage plans raise their federal star ratings, arriving just one day after government data revealed a drop in qualifying contracts for bonus payments. The software utilizes predictive analytics, simulation modeling, and agent-driven engagement to target the metrics managed by the Centers for Medicare & Medicaid Services (CMS).
Federal spending on the Medicare Advantage quality bonus program reached at least $13.4B in 2026, accounting for roughly 2.3 percent of projected payments to the program according to data from KFF. Plans that achieve a rating of four stars or better out of five secure a higher spending benchmark, typically increasing by five percentage points. Contracts scoring above 4.5 stars retain 70 percent of the gap between the benchmark and their bid.
Qualifying for those funds has grown more difficult. CMS published its 2027 ratings on October 8, showing that 188 out of 508 rated contracts reached four stars or higher. That figure represents a decline from the 229 out of 516 contracts that achieved the benchmark a year prior. The share of members enrolled in bonus-eligible plans dropped to 68 percent in 2026, down from 75 percent, marking the lowest level since 2018. Five-star contracts dropped from 22 to 15.
Software Targets Contested Federal Metrics
The software addresses a scoring system that faces scrutiny from federal advisers and healthcare providers alike. The Medicare Payment Advisory Commission (MedPAC), which advises Congress on Medicare, argues that the current star ratings rely on too many measures, fail to account for social risk, and are reported at the contract level rather than the plan level. Perficient’s new platform aims to optimize a scoring mechanism that government advisers characterize as a weak proxy for care.
The program’s cost has drawn legislative attention. The Congressional Budget Office estimated in 2018 that scrapping the quality bonus program would save almost $100B over a decade. Meanwhile, healthcare providers are pursuing legal and technological avenues to secure additional funding. Clover Health secured a recalculation of its 2026 scores, a move KFF estimates adds about $600M to 2027 payments, though CMS appealed that decision in July. Humana also filed suit after one large contract dropped from 4.5 stars to 3.5 stars, though courts have thus far sided with CMS.
Ownership and Corporate Background
Perficient operates under the ownership of EQT, a Swedish buyout group managing approximately €130B. EQT previously engaged in talks with Alphabet regarding model licensing for its portfolio before purchasing Perficient for roughly $3B and delisting it in October 2024. Perficient employs around 7,000 people and maintains European delivery hubs located in Romania, Serbia, and the United Kingdom.
While consultancies and healthcare providers deploy software to navigate scoring formulas, federal agencies are applying automated screening from the opposite direction. The Department of Health and Human Services (HHS) began screening insurance claims for fraud prior to payment in May, covering Medicare, Medicaid, and the insurance marketplace. Litigation and software are routes to the same half-star.
