Medicare Advantage Star Ratings
Expert articles and analysis related to medicare advantage star ratings.
AI Summary — Last 7 Days
Medicare Advantage pressure is concentrating around the core economics of VBC: plan-level risk adjustment accuracy, Star-driven bonus economics, and utilization management friction. MedPAC’s new work on MA risk adjustment accuracy at the plan level reinforces federal scrutiny of whether coding intensity and plan-level payment variation are distorting benchmarks, while reporting on plan exits and delayed member notices underscores the operational risk for providers tied to MA networks and capitated arrangements. At the same time, market enthusiasm around an MA rate “surprise” is colliding with continued backlash over prior authorization and coding enforcement, keeping the Trump administration’s CMS under Dr. Mehmet Oz in a balancing act between MA stability, payment integrity, and beneficiary access.
Related Articles
When “Paying Correctly” Means Paying Nothing: How to Make Medicare Advantage Accountable
By FRANK LEAHY This is the second of two pieces. The first told the story of “Rick,” a 77-year-old Humana Medicare Advantage member who nearly lost his sight in a months-long runaroundContinue reading...
Insurers Have Already Told Wall Street Which Advantage Plans Die on December 31. Members Are the Last to Know, and the Letter Isn’t Due Until October 2.
Insurers Have Already Told Wall Street Which Advantage Plans Die on December 31. Members Are the Last to Know, and the Letter Isn’t Due Until October 2.  AOL.com
Insurers Have Already Told Wall Street Which Advantage Plans Die on December 31. Members Are the Last to Know, and the Letter Isn't Due Until October 2. - 24/7 Wall St.
Insurers Have Already Told Wall Street Which Advantage Plans Die on December 31. Members Are the Last to Know, and the Letter Isn't Due Until October 2.  24/7 Wall St.
UNH, HUM, CNC Stocks Rally On Medicare Advantage Rate Surprise
UNH, HUM, CNC Stocks Rally On Medicare Advantage Rate Surprise  Stocktwits
Accuracy of Medicare Advantage risk adjustment at the plan level - medpac.gov
Accuracy of Medicare Advantage risk adjustment at the plan level  medpac.gov
Examining use of post-acute care services by beneficiaries in fee-for-service Medicare and Medicare Advantage - MedPAC (.gov)
Examining use of post-acute care services by beneficiaries in fee-for-service Medicare and Medicare Advantage  MedPAC (.gov)
Medicare is Changing in 2027: 8 Things That Will Impact Your Wallet
Medicare is Changing in 2027: 8 Things That Will Impact Your Wallet  Kiplinger
Medicare spent hundreds of millions of dollars on ineligible drugs, audit finds
Shoddy CMS oversight is to blame, and the agency needs to do better, the HHS Office of the Inspector General said. The CMS concurred.
“We’re Sorry, That’s the Policy”: How a Medicare Advantage Runaround Nearly Cost a Senior His Sight
By FRANK LEAHY On a gray February morning, I sat in my office in Inverness, in rural northern California, with the phone pressed to my ear, jotting down notes and Humana referenceContinue reading...
In 2027 the Flex Card Checks Your Cart at the Register. What the Plan Won’t Cover Can Be Declined With a Line Behind You. - 247wallst.com
In 2027 the Flex Card Checks Your Cart at the Register. What the Plan Won’t Cover Can Be Declined With a Line Behind You.  247wallst.com