ACHP Applauds CMS Proposed Reforms to Medicare Advantage Program
ACHP welcomes CMS proposed reforms to Medicare Advantage Star Ratings and risk adjustment that prioritize health outcomes over process measures and address coding gaming
ACHP welcomes CMS proposed reforms to Medicare Advantage Star Ratings and risk adjustment that prioritize health outcomes over process measures and address coding gaming
Health equity is a core priority for ACHP members, but the new Health Equity Index (HEI) reward may end up creating a dilemma for some of the health plans most invested in its success.
New analysis by ACHP shows that gaming within the Medicare Advantage program by large national carriers persists, wasting tens of billions of taxpayer dollars each year. The examination of risk adjustment payments found that the largest national MA insurer collected up to $785 more per beneficiary than local, nonprofit plans in 2023 alone. That difference cost Medicare more than $6 billion.
