Background on Medicare Advantage Rates

By April 11, 2026Commentary1 min read

Several readers asked questions about the recent post on Medicare Advantage rate-setting.  More information can be found in the following documents.

As usual, the Kaiser Family Foundation provides an excellent overview of how Medicare Advantage plan payments are set.  (KFF Brief) 

The CMS explanation of the recently released 2027 MA rates is here, quite long.  See page 40 and following.  (CMS Release)

The MedPAC comment letter on current CMS rate-setting formulas is found here and gives good background on the issues MedPAC considers important.  (MedPAC letter)

And if you read the recent MedPAC annual report to Congress you will get the Commission’s full perspective on MA rates.  (MedPAC Report)

Kevin Roche

Author Kevin Roche

The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry through Roche Consulting, LLC. Mr. Roche is available to assist health care companies through consulting arrangements and may be reached at khroche@healthy-skeptic.com.

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