McKnight's January 16, 2024
Medicare Advantage risk scores continue to rise, inflating payments to the private plans that far exceed their actual costs, staff for a Congressional advisory commission warned members Friday.
The Centers for Medicare & Medicaid Services uses risk scores, based on patient demographics and their needs, to establish payments to plans during each bid season.
Medicare Payment Advisory Commission staff highlighted disparities between payments to MA and funding for traditional Medicare in a status update to MedPAC commissioners in Washington Friday.
“Overall, we estimate that coding and [patient] selection will cause MA payments to be 23% above Fee-For-Service spending in 2024,” said analyst Luis Serna. “That difference translates into additional MA payments that are a projected $88 million.”
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