Home Page
postheader postheader postheader postheader postheader postheader

This was released from CMS today (2/19/2016):

2017 Medicare Advantage and Part D Advance Notice and Draft Call Letter

Today, CMS released proposed updates to the Medicare Advantage (MA) and Part D programs through the 2017 Advance Notice and Draft Call Letter. Through these policies, CMS is proposing updates to the program designed to improve the accuracy of payments to plans serving beneficiaries who are dually eligible for Medicare and Medicaid.

CMS is committed to making the Medicare Advantage and Part D programs high quality health care options for all Medicare beneficiaries – including low income and dually eligible beneficiaries.  As part of that commitment, the 2017 Advance Notice and Draft Call Letter propose program adjustments designed to improve the precision of payments to plans serving these important populations. Specifically, CMS is proposing updates to the Risk Adjustment Model used to calculate payments to Medicare Advantage plans and to the Star Rating system used to evaluate plan performance. In both cases, the updates reflect a public process through which CMS shared research findings and solicited public comment.

A Growing and Improving Program that Remains Affordable

The Medicare Advantage and Part D programs continue to grow and thrive. In the Medicare Advantage program:

  • Enrollment continues to grow – MA enrollment increased by more than 50 percent since passage of the Affordable Care Act to an all-time high of more than 17.1 million – or 32 percent of – Medicare beneficiaries enrolled in a Medicare Advantage plan.
  • Plan quality continues to improve – the percentage of MA enrollees in four or five star contracts has almost quadrupled since 2009 to 71 percent.
  • Premiums remain affordable – average premiums today are lower than before the Affordable Care Act went into effect, dropping about 10 percent between 2010 and 2016.

2017 Advance Notice/Payment Changes

Proposed changes in the 2017 Advance Notice are intended to improve payment precision and encourage quality, while continuing to protect beneficiaries from significant increases in premiums and out of pocket costs.

Net Payment Impact

The chart below shows the expected impact of the proposed policy changes on plan payments relative to last year.

Year-to-Year Percentage Change in Payment

 

 

Impact

 

2017

Advance Notice

Effective Growth Rate

 

3.0%

Transition to ACA rules

 

-0.8%

Rebasing/Re-pricing

 

TBD1

Improved star ratings

 

0.1%

Risk model revision

 

-0.6%

MA coding intensity adjustment

 

-0.25%

Normalization

 

-0.1%

Expected Average Change in Revenue from Advance Notice Policies

 

1.35%

Coding trend

 

2.2%

Expected Average Change in Revenue

 

3.55%

1 Rebasing/re-pricing impact is dependent on finalization of average geographic adjustment index and will be available with the publication of the Rate Announcement

Excerpt from CMS Newsroom:

https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-02-19.html

Posted 12:13 PM  View Comments

Share |


No Comments


Post a Comment
Name
Required
E-Mail
Required (Not Displayed)
Comment
Required


All comments are moderated and stripped of HTML.
Submission Validation
Required
CAPTCHA
Change the CAPTCHA codeSpeak the CAPTCHA code
 
Enter the Validation Code from above.
NOTICE: This blog and website are made available by the publisher for educational and informational purposes only. It is not be used as a substitute for competent insurance, legal, or tax advice from a licensed professional in your state. By using this blog site you understand that there is no broker client relationship between you and the blog and website publisher.
Blog Archive


View Mobile Version
   
HOME PAGE ABOUT US GET A QUOTE REFER A FRIEND CONTACT US
708 N Marion St | Kirksville, MO 63501 | Phone: 660.665.0600
419 W Ree St | Moberly, MO 65270 | Phone: 660.234.5835
Logo
Powered by Insurance Website Builder