CareStars › All contracts › H5938
H5938 · Capital Health Plan: 2027 Star Rating
H5938 (Capital Health Plan, CAPITAL HEALTH PLAN) earned 4.5 stars in the 2027 Medicare Advantage Star Ratings, the same as in 2026. Parent company: Guidewell Mutual Holding Corporation. Plan type: Local CCP.
2027 overall CMS
4.5
Part C 4.5 · Part D 4.0
2026 overall CMS
4.5
Part C 5.0 · Part D 4.5
Change Calc
Same
2027 vs 2026
Members Calc
26,493
CMS county files, October 2026
Open H5938 in CareStars: bonus at stake, measures to fix, local rivalsTalk to Carelytics about H5938
What stands out for H5938
- Most of its members are in Florida (26,493, 0.9% of Medicare Advantage members in CMS county files there). Calc
- Of the 36 rated contracts with members in Florida, 3 have a higher 2027 rating and 9 have the same rating. Calc
- Largest other contract in Florida: H1036 · Humana, 4.5 stars, 541,186 members. Calc
- At 4.5 stars it is at or above the 4-star line that sets 2028 quality bonus payments. CMS rule
- 20 of its 42 rated measures are at 5 stars; 3 are at 1 or 2 stars. Calc
- Its Part D rating (4.0) is lower than its Part C rating (4.5). CMS
Weakest high-weight measures
Measures with weight 2 or more and the lowest stars. These move the overall rating most.
- Medication Adherence for Diabetes Medications (D08, weight ×3): 2 stars, score 88
- Health Plan Quality Improvement (C29, weight ×5): 3 stars
- Controlling High Blood Pressure (C14, weight ×3): 3 stars, score 83
- Plan All-Cause Readmissions (C17, weight ×3): 3 stars, score 11
- Medication Adherence for Cholesterol (Statins) (D10, weight ×3): 3 stars, score 89
All 2027 measure scores Sourced: CMS
| Measure | Weight | Score | Stars |
|---|---|---|---|
| Breast Cancer Screening (C01) | ×1 | 86 | 5 |
| Colorectal Cancer Screening (C02) | ×1 | 85 | 5 |
| Annual Flu Vaccine (C03) | ×1 | 70 | 4 |
| Improving or Maintaining Physical Health (C04) | ×3 | 74 | 4 |
| Improving or Maintaining Mental Health (C05) | ×3 | 87 | 5 |
| Monitoring Physical Activity (C06) | ×1 | 55 | 4 |
| Osteoporosis Management in Women who had a Fracture (C10) | ×1 | 67 | 4 |
| Diabetes Care - Eye Exam (C11) | ×1 | 87 | 5 |
| Diabetes Care - Blood Sugar Controlled (C12) | ×3 | 93 | 5 |
| Kidney Health Evaluation for Patients with Diabetes (C13) | ×1 | 77 | 4 |
| Controlling High Blood Pressure (C14) | ×3 | 83 | 3 |
| Reducing the Risk of Falling (C15) | ×1 | 55 | 2 |
| Improving Bladder Control (C16) | ×1 | 54 | 5 |
| Plan All-Cause Readmissions (C17) | ×3 | 11 | 3 |
| Statin Therapy for Patients with Cardiovascular Disease (C18) | ×1 | 85 | 2 |
| Transitions of Care (C19) | ×1 | 81 | 5 |
| Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions (C20) | ×1 | 65 | 3 |
| Getting Needed Care (C21) | ×2 | 84 | 5 |
| Getting Appointments and Care Quickly (C22) | ×2 | 89 | 5 |
| Customer Service (C23) | ×2 | 92 | 5 |
| Rating of Health Care Quality (C24) | ×2 | 89 | 5 |
| Rating of Health Plan (C25) | ×2 | 93 | 5 |
| Care Coordination (C26) | ×2 | 87 | 3 |
| Complaints about the Health Plan (C27) | ×2 | 0.06 | 5 |
| Members Choosing to Leave the Plan (C28) | ×2 | 1 | 5 |
| Health Plan Quality Improvement (C29) | ×5 | – | 3 |
| Plan Makes Timely Decisions about Appeals (C30) | ×2 | 100 | 5 |
| Reviewing Appeals Decisions (C31) | ×2 | 100 | 5 |
| Call Center - Foreign Language Interpreter and TTY Availability (C32) | ×2 | 97 | 4 |
| Call Center - Foreign Language Interpreter and TTY Availability (D01) | ×2 | 97 | 4 |
| Complaints about the Drug Plan (D02) | ×2 | 0.06 | 5 |
| Members Choosing to Leave the Plan (D03) | ×2 | 1 | 5 |
| Drug Plan Quality Improvement (D04) | ×5 | – | 4 |
| Rating of Drug Plan (D05) | ×2 | 90 | 5 |
| Getting Needed Prescription Drugs (D06) | ×2 | 90 | 4 |
| MPF Price Accuracy (D07) | ×1 | 100 | 5 |
| Medication Adherence for Diabetes Medications (D08) | ×3 | 88 | 2 |
| Medication Adherence for Hypertension (RAS antagonists) (D09) | ×3 | 91 | 4 |
| Medication Adherence for Cholesterol (Statins) (D10) | ×3 | 89 | 3 |
| Statin Use in Persons with Diabetes (SUPD) (D11) | ×1 | 87 | 3 |
| Concurrent Use of Opioids and Benzodiazepines (COB) (D12) | ×1 | 16 | 3 |
| Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH) (D13) | ×1 | 6 | 4 |
Where H5938 has members
Florida (26,493)
Want to move a measure before December 31? Marples, the Carelytics care gap and member engagement platform, ranks the members whose open gaps would move a measure across the next cut point and reaches them by secure text. See how Marples works
Other Guidewell Mutual Holding Corporation contracts
H1035 · Florida Blue HMO · 3.5 starsH4005 · Triple-S Advantage · 4.5 starsH5434 · Florida Blue · 3.0 starsH5774 · Triple S Advantage · 5.0 stars
Sources: CMS 2027 and 2026 Star Ratings data tables (CMS Part C and D performance data); CMS monthly enrollment by contract and county (October 2026). Sourced: CMS marks figures taken from CMS. Calculated marks figures Carelytics added up or compared. Built 2026-10-25.