Medicare Advantage plans face ‘double whammy’ of pent-up care demand and risk scores: experts

Fierce Health Payers June 5, 2020
Robert King

Medicare Advantage plans need to figure out how the delay of care due to the COVID-19 pandemic will impact their risk scores in the long term, experts say.

Experts gave insights into the long-term financial future of Medicare Advantage during a panel hosted as part of FierceHealthPayer’s Virtual Series.

Many of the services that have been deferred by consumers would have made up the sources of diagnoses that plans would have used to establish risk scores for their enrollees, said Matt Kazan, principal at the consulting firm Avalere Health.

Risk scores for Medicare Advantage plans reflect a beneficiary’s expected healthcare costs versus an average score. A plan’s score impacts how much money they get from Medicare.

Plans could have lower...

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