Fact Sheet: A Policymakers' Guide to Medicare Advantage Payment

This fact sheet, funded by West Health and produced by the Medicare Policy Initiative, part of the Center on Health Insurance Reform at Georgetown University, describes the different steps in Medicare Advantage (MA) payment policies, breaking down the process from benchmark calculations to risk adjustment and quality bonus payments into an easy-to-digest guide. This MA payment guide maps key statutory authorities to each MA payment topic, lays out the timeline of CMS and plan payment milestones for 2026, and provides a reference to the relevant MA payment regulations.