2025 SOA Health Meeting: Session 9D: Carving In/Out Medicare Part D & Supplemental Benefits and Affect a Provider's Risk Exposure -06.24.25- Recording

Offer a discussion on what should be carved in vs. out in a Medicare Advantage risk arrangement and how it ultimately impact a provider's risk revenue. Show why carving out supplemental benefits may or may not solve for the concerns around risk exposure for providers. There are a lot of additional supplemental benefits being added in MA contracts in recent years and many providers don't want to be on the hook for it. However, their revenue is likely being affected in similar ways to a downstream prospective where providers decide whether it's carved in or out.
The panel will walk through bid revenue mechanics and show how the revenue flows downstream to risk contracts using a few different examples and calculate a provider's resulting risk exposure.