{"id":25192,"date":"2025-11-21T08:37:01","date_gmt":"2025-11-21T13:37:01","guid":{"rendered":"https:\/\/medicarereport.org\/?p=25192"},"modified":"2025-11-21T08:37:02","modified_gmt":"2025-11-21T13:37:02","slug":"chart-reviews-increase-payments-to-medicare-advantage-insurers-for-1-in-6-enrollees","status":"publish","type":"post","link":"https:\/\/medicarereport.org\/?p=25192","title":{"rendered":"Chart Reviews Increase Payments to Medicare Advantage Insurers for 1 in 6 Enrollees"},"content":{"rendered":"\n

(Authors: Jeannie Fuglesten Biniek, Nolan Sroczynski, and Tricia Neuman for The Kaiser Family Foundation Published: Nov 20, 2025)<\/p>\n\n\n\n

Federal payments to Medicare Advantage plans are adjusted for the health status of the plans\u2019 enrollees through a process known as risk adjustment. Generally, payments are higher for people with more health conditions and lower for people with fewer health conditions. The purpose of risk adjusting payments is to ensure Medicare Advantage plans receive sufficient payments to cover the expected costs of enrollees with more health conditions who have higher expected health care spending. However, it also provides an incentive to Medicare Advantage insurers to document the health conditions of their enrollees more comprehensively than is done for traditional Medicare beneficiaries, making Medicare Advantage enrollees look sicker and increasing payments from the federal government. Continue reading here…<\/a><\/p>\n\n\n\n

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Notice:<\/strong>\u00a0The link provided above connects readers to the full content of the posted article. The URL (internet address) for this link is valid on the posted date; medicarereport.org cannot guarantee the duration of the link\u2019s validity. Also, the opinions expressed in these postings are the viewpoints of the original source and are not explicitly endorsed by AMAC, Inc.; the AMAC Foundation, Inc.; or medicarereport.org.<\/p>\n","protected":false},"excerpt":{"rendered":"

(Authors: Jeannie Fuglesten Biniek, Nolan Sroczynski, and Tricia Neuman for The Kaiser Family Foundation Published: Nov 20, 2025) Federal payments<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[32,21,6,9],"tags":[80,238,61,62,94],"class_list":["post-25192","post","type-post","status-publish","format-standard","hentry","category-cms","category-health-care-finance","category-medicare-general","category-medicare-advantage","tag-cms","tag-healthcare-finance","tag-medicare","tag-medicare-advantage","tag-older-adults"],"_links":{"self":[{"href":"https:\/\/medicarereport.org\/index.php?rest_route=\/wp\/v2\/posts\/25192","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicarereport.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicarereport.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicarereport.org\/index.php?rest_route=\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/medicarereport.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=25192"}],"version-history":[{"count":1,"href":"https:\/\/medicarereport.org\/index.php?rest_route=\/wp\/v2\/posts\/25192\/revisions"}],"predecessor-version":[{"id":25193,"href":"https:\/\/medicarereport.org\/index.php?rest_route=\/wp\/v2\/posts\/25192\/revisions\/25193"}],"wp:attachment":[{"href":"https:\/\/medicarereport.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=25192"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicarereport.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=25192"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicarereport.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=25192"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}