Medicare Advantage and Risk

The government pays Medicare Advantage plans a set fee every month. This fee is based on a "risk score", which is supposed to be a measure of how sick each patient is. The sicker the patient, the higher the payment. Would you believe that between 2004 and 2008, the risk scores grew twice as fast as they would have had the same person remained in traditional Medicare? 

It was like magic; the Centers for Medicare and Medicaid Services found that it was “extremely unlikely” the MA patients were actually getting that much sicker. Yet, nothing was done to curb this increase in scores. Thus, from 2008 to 2013, “improper” payments amounted to $70 billion, mostly due to overbilling.