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Originally Posted by MidWestIA
Only if there are not many massive med bills -
The government pays Medicare Advantage plans a set rate per person, per year (around $12,000 in 2019, not including Part D–related expenses) under what is called a “risk-based” contract. That means that each plan agrees to assume the full risk of providing all care for that inclusive amount.
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Why Medicare Advantage costs taxpayers billions more than it should – Center for Public Integrity
There seems to be a further factor included into the meaning of "risk based" contract and the set rate per person? Refer you to the article above which adds a further definition of "Risk Based" and how the government pays the set rate. While the contracted MA Plan assumes full risk of providing all care for those persons insured, there appears to be a "Risk Factor" negotiated by the contractor and CMS regarding the severity of needs of the pool of covered personnel.
Excerpt from cited article.
"Risk score:
Since 2004, CMS has paid Medicare Advantage plans based on a risk score that is supposed to assess the overall health of each patient. Medicare pays higher rates for sicker patients that are likely to require more costly medical services and less for healthy people."
This Risk Factor negotiation has been a topic cited as a source of potential abuse of the MA plans.