The impact of CMS's recent final Medicare Advantage (MA) payment notice and Call Letter ...

... "depends on the composition of your membership. This is a hit of probably somewhere between 2.5% and 4% to plans that have a lot of group retirees [Employer Group Waiver Plans, or EGWPs]. Remember, 19% of MA is in group, and so the EGWP provision really is a big change and I think a lot of the folks in the [Obama] administration viewed that as some corporate welfare that they wanted to start whittling away at.... The risk adjustment piece could be a minor headwind as the plans shift to more encounter data, which is ultimately going to make the risk adjuster a lot more accurate. And by our read it's a big boost for plans with large populations of low-income subsidy and fully dual-eligible beneficiaries."

— John Gorman, founder and executive chairman of Gorman Health Group, told AIS's Health Plan Week.