Whether a Medicare Advantage plan is just beginning operations or has participated in the market for years, it is critically important to understand how Medicare Advantage plans are paid. This allows a Medicare Advantage plan to appropriately monitor and segment their financial performance, and identifies areas where the plan may potentially work to increase revenue.
This report discusses various sources of revenue, how to appropriately separate Part C and Part D revenue, the timing of Medicare Advantage payments from the Federal government, levers that may increase Medicare Advantage revenue, how to calculate revenue payments by segment based on the Bid Pricing Tool and Monthly Membership Reports, and reconciliation payments for Part D.
