Risk Factors Update Summary
- Final Part C contract-level RADV Audit Rule issued in January 2023 may impact Oak Street Health and Signify Health financial performance.
- Recent acquisitions of Signify Health and Oak Street Health introduce new risks beyond historical ones.
- RADV Audit Rule permits extrapolation of OIG contract level audits for payment years 2018 forward.
- Expansion from 12 to 17 states in January 2024 may impact profitability of Public Exchange products.
- Changes in the IRA to the Part D program from 2023 to 2032 could shift more claim liability to plans.
- Finalized Medicare Advantage rates for 2024 show an expected average decrease in revenue of 1.12%.
- Challenges in obtaining complete encounter data could result in financial fines and penalties for noncompliance.
- A decrease in star ratings for Aetna National PPO from 4.5 to 4.0 may impact quality bonus payments.
- Changes to Medicaid programs could impact premium rates received and Medicaid membership assignment.
- Changes to the hierarchical condition category model could impact RAF scores for Medicare Advantage beneficiaries.
- Proposed limitations on broker and agent earnings for marketing Medicare Advantage and Part D plans.
- Failure or disruption of information technology systems could adversely affect operating results.
Full Text Changes in Most Recent 10-K
Intended use: review the highlighted statements. These are additions to the risk factors disclosure in the most recent 10-K filing compared to the previous 10-K filing. Deleted and moved text is less important and is shown for context.
To view the full company filings, click on the following link to be taken to the SEC EDGAR database landing page for the company: https://www.sec.gov/edgar/browse/?CIK=64803&owner=exclude
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