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UnitedHealth Group brought in an estimated $3.7 billion in payments linked to health risk assessments and chart reviews in 2023, according to an audit published by HHS’ Office of Inspector General.
The audit, published Oct. 24, examined “questionable” payments linked to health risk assessments and chart reviews.
Medicare Advantage plans conduct HRAs to collect information about enrollee health status. These assessments are sometimes conducted by providers as part of beneficiaries’ annual wellness visits, or in enrollees homes. MA plans also conduct chart reviews to find diagnoses that may have been missed by providers during visits.
MA plans are reimbursed by the federal government based on enrollees’ health risk. The policy creates financial incentives for insurers to “misrepresent” enrollees’...
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