Medicare Advantage Payments The Centers for Medicare & Medicaid Services (CMS) pays Medicare Advantage plans a monthly, per-person, fixed rate, also known as a capitated payment, to deliver care to Medicare beneficiaries. This capitated payment…
Risk Adjustment
Fact Sheet
Coding and Payment in Medicare Advantage
January 12, 2021 Key Facts: • Medicare Advantage plans are paid a capitated amount based on the average cost of FFS Medicare. That payment is risk adjusted for each enrollee based on health status. • Medicare Advantage relies…
Report
The Impact of COVID-19 on Medicare Advantage Risk Scores and Payment
November 5, 2020 This analysis, conducted by Avalere Health and commissioned by Better Medicare Alliance, considers how reductions in service utilization as a result of the COVID-19 pandemic may lead to insufficient data to accurately determine 2021 Medicare…