risk scores

Release: Medicare Advantage Risk Adjustment is Failing, Costing Taxpayers Billions of Dollars

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.

Medicare Advantage’s Misaligned Incentives: Risk Adjustment Pays More Than Quality

High-quality health plans that meet consumers’ needs should be rewarded over plans that prioritize chasing risk adjustment revenue. In reality, aggressive risk adjustment practices in Medicare Advantage (MA) are delivering bigger payments than bonuses for high-quality coverage and care.

Comments on the 2023 Medicare Advantage Advance Notice

ACHP’s comments on the 2023 Medicare Advantage Advance Notice provide recommendations on the benchmark cap and risk scores.

Tag: risk scores

Release: Medicare Advantage Risk Adjustment is Failing, Costing Taxpayers Billions of Dollars

Medicare Advantage’s Misaligned Incentives: Risk Adjustment Pays More Than Quality

Comments on the 2023 Medicare Advantage Advance Notice