ACHP Recommendations for an Inferred Risk Adjustment Model
ACHP urges CMS to preserve separate payment terms for state directed payments and coordinate with NAIC so risk-based capital reflects the risk plans bear.
ACHP urges CMS to preserve separate payment terms for state directed payments and coordinate with NAIC so risk-based capital reflects the risk plans bear.
ACHP member plans averaged 4.23 Stars in 2027 Medicare Advantage Star Ratings, vs. 3.96 for other plans, and earned 13 of 18 five-star NCQA ratings.
ACHP urges CMS to simplify risk adjustment, modernize network adequacy and refine Star Ratings in 2028 to protect Medicare Advantage beneficiary choice.
ACHP applauds Rep. Mike Kelly’s MA STARS Act, which centers Medicare Advantage Star Ratings on clinical quality, patient outcomes and patient experience.
National insurers pulled back from Medicare Advantage in 2026, disrupting 4.6M beneficiaries. ACHP’s regional nonprofit plans stepped in to keep access.
