Becker's Healthcare August 4, 2023
Changes in CMS’ risk model for Medicare Advantage and rising medical costs among the Medicare population could lead to changes in benefit design, payer executives told investors in second-quarter earnings calls.
In March, CMS finalized new risk adjustment regulations that will change how some high-risk conditions are reimbursed. Payer groups said the changes amounted to a funding cut for the program.
Executives told investors the changes were factored into 2024 bids, but they were able to maintain key benefits.
Tim Noel, CEO of UnitedHealthcare’s Medicare and retirement business, said the new risk model had more of an effect on the company’s 2024 Medicare Advantage bids than rising utilization.
“Certainly, we’ve been talking a lot about care...
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