Becker's Healthcare September 3, 2025
A group representing nonprofit health plans is raising concerns over what it claims is a wide variation in Medicare Advantage risk adjustment scores across insurers, leading to what it calls a “gaming” of MA payments to the benefit of for-profit insurers.
The Alliance of Community Health Plans compared CMS data to its nonprofit member health plans. The average MA risk score in 2023 at UnitedHealthcare was 36.2% higher than ACHP members and Humana’s was 19.2% higher. The report also found a significant average per-patient difference in payments...
Today's Sponsors
Today's Sponsor