Risk Adjustment & Benchmarking

MedPAC’s $76 billion Medicare Advantage overpayment estimate is again central to the risk-adjustment fight, with Chair Amol Navathe defending the methodology as MA insurers press Congress to change how coding intensity and benchmark comparisons are calculated (Medical Daily). For VBC stakeholders, the immediate implication is continued pressure on MA risk adjustment, Star Ratings-linked revenue, and benchmark integrity—raising the likelihood that CMS under the Trump administration will face competing demands to tighten payment accuracy while preserving plan participation and provider-aligned MA value-based contracts.