Fact Based List:
5 Things to Know About the "Crosswalking" of MA Ratings
Submitted by Anonymous on Tue, 03/20/2018 - 15:51
- Medicare ranks MA plans on a quality scale, and pays bonuses to plans with high ratings. If an MA plan is not set to receive a financial bonus, companies will merge patients into higher score plans.
- Using this tactic, health insurance companies are able to boost the ratings of Medicare Advantage plans without actually improving on quality measures.
- Insurers have used this tactic over the past few years. Insurers shuffled roughly 1.45 million Medicare Advantage members into higher-rated plans for 2018, according to WSJ.
- Paul Ginsburg, PhD, a professor at the University of Southern in Los Angeles and a member of the Medicare Payment Advisory Commission, told WSJ crosswalking "is nothing more than gaming the system."
- The budget deal signed into law in February is expected to cut down on the practice of crosswalking, according to WSJ.
Source: Becker's Hospital Review
Source URL: https://www.beckershospitalreview.com/payer-issues/how-healt...
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