Medicare Advantage payment is a complex web, with a multitude of equations, calculations, and risk adjustments weaving together in various ways. As policymakers consider changes to the MA program, it is important to understand how proposed changes can impact the different aspects of the MA payment cycle.
Read the guide to learn more about:
- How benchmarks are structured and calculated
- The Quality Bonus Payment Program
- The risk adjustment process
- The implications to MA payment from the version 28 risk adjustment model
- Timeline of regulatory actions for MA payment and enrollment
This guide is designed to help policymakers and key stakeholders develop more comprehensive and effective policy solutions by referencing this tool to understand where policies may reach functional and technical challenges in operationalization.