The insurer argued the CMS didn’t follow its stated methodology for calculating quality scores, causing its rating to drop and risking millions of dollars in payments.| Healthcare Dive
The Medicare trustees’ new projection for insolvency is five years later than previous forecasts, but budget hawks warned action is still needed to shore up the insurance program’s finances.| Healthcare Dive
The redo comes after regulators lost two court cases over the methodology used to determine 2024’s quality ratings and should result in hundreds of millions of dollars in additional bonuses to plans.| Healthcare Dive
Star ratings bonuses reached $12.8 billion, according to the KFF, as the Medicare program faces a growing spending crisis.| Healthcare Dive
Friday’s district court ruling is the latest suggesting the CMS might have to recalculate every MA plan’s star rating score due to an administrative oversight.| Healthcare Dive
About 42% of Medicare Advantage plans that offer prescription drug coverage in 2024 earned four or more stars, compared with just over half this year.| Healthcare Dive
Hundreds of thousands of seniors could switch plans during next year’s open enrollment, depending on how drastically the MA market giants slash benefits in an attempt to improve profits.| Healthcare Dive
Using health insurer financial data for 2023, we find that in 2023, per enrollee gross margins were highest in the Medicare Advantage market, and medical loss ratios were lowest in the individual insurance market. Across most markets, gross margins have been relatively stable in recent years.| KFF
