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How Medicare Advantage benchmarks differ for ESRD beneficiaries versus other Medicare beneficiaries

6 April 2020

The Medicare Advantage benchmark rate for end-stage renal disease (ESRD) beneficiaries is calculated using a different methodology to other beneficiaries. As ESRD beneficiaries become a larger share of a Medicare Advantage plan’s total enrollment, there may be unintended revenue and cost consequences for the plan.

This paper was sponsored by the Blue Cross Blue Shield Association. It was updated in April 2020.


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