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STAT+: Health insurers score major win with higher 2027 Medicare Advantage rates
Companies that sell Medicare Advantage plans will receive a 2.5% pay bump on average in 2027, up significantly from what was proposed and a win for an industry that has experienced higher medical costs and has opposed nearly all reforms to the lucrative taxpayer-financed program.
More importantly, the Trump administration scrapped its proposal that would have used more updated data in the payment process, ensuring that Medicare Advantage insurers retain billions of dollars.
In addition to base payments, Medicare Advantage insurers get paid based on how sick their members. This process is known as risk adjustment and has been flagged by watchdogs, auditors, and federal attorneys as rife with abuse. Trump officials proposed using newer data that goes into seniors’ “risk scores,” but after intense industry pushback over the past two months, they are dropping the proposal for now.
Companies that sell Medicare Advantage plans will receive a 2.5% pay bump on average in 2027, up significantly from what was proposed and a win for an industry that has experienced higher medical costs and has opposed nearly all reforms to the lucrative taxpayer-financed program.
More importantly, the Trump administration scrapped its proposal that would have used more updated data in the payment process, ensuring that Medicare Advantage insurers retain billions of dollars.
In addition to base payments, Medicare Advantage insurers get paid based on how sick their members. This process is known as risk adjustment and has been flagged by watchdogs, auditors, and federal attorneys as rife with abuse. Trump officials proposed using newer data that goes into seniors’ “risk scores,” but after intense industry pushback over the past two months, they are dropping the proposal for now.