Major insurers are gaming Medicare Advantage’s risk adjustment system to reap higher payments from the government, costing Medicare billions of dollars, according to a new analysis of CMS data.

UnitedHealthcare, the biggest MA insurer in the U.S., collected up to $785 more per beneficiary than local nonprofit plans in 2023, costing Medicare more than $6 billion in excess payments that year, according to the research released Wednesday from the Alliance of Community Health Plans, a group that represents local and regional nonprofit payers.

Similarly, Humana, the second-biggest MA payer, collected $423 more per beneficiary that year than if those members were in ACHP member plans, costing Medicare an additional $4 billion, according to the group.

The ACHP’s findings are concerning given a

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