Does this Medicare Advantage county still hold up?
Enter one county's payment, cost and scale. You get the margin, the break-even membership and three stress tests, with a stay, restructure or review-exit result.
Example values are illustrative. Replace them with your own.
Method and limits
This is a directional screen, not a bid. Actual MA payment involves standardization, normalization, county weighting and actuarial assumptions not modeled here. Rebate dollars must fund supplemental benefits or premium reductions; include those benefits in medical cost. Quality bonus: 5% for 4 stars or more, 10% in double-bonus counties. Rebate share: 70% at 4.5 stars or more, 65% at 3.5 to 4, 50% below 3.5. Benchmarks are updated every April with the CMS rate announcement.