The CMS (Centers for Medicare and Medicaid Services) on the day of Friday issued proposed changes for the Medicare Advantage and Part D prescription drug plans for the year 2017, involving a 1.35% increase in the net payment rate for Medicare Advantage, CMS stated.
This is an average amount for Medicare Advantage policies, and individual plans’ experiences will vary, CMS claimed.
The anticipated average increase in insurers’ revenue is estimated at 3.55% when other threat factors are thought, in accordance to CMS.
America’s Health Insurance Plans, which has lobbied to keep present rates, issued a statement claiming it was continuing to consider the notice’s affect.
“More than 360 members of Congress and two million seniors in the Coalition for Medicare Choices asserted CMS to secure Medicare Advantage from any further cuts,” stated AHIP President and CEO Marilyn Tavenner. “While we are in the procedure of carefully considering all of these provisions, we will be searching closely at any proposals that would undermine health policies’ care coordination and disease management plans, particularly for low-income individuals. It is seriously significant that the agency finalize plans that make sure the long-term stability and continued progress of the program for millions of beneficiaries who rely on Medicare Advantage for their coverage.”
CMS stated. “Policies that make better the quality of care they deliver to enrollees can observe higher updates and can grow and enhance the advantages they provide to enrollees.”
Additionally, CMS stated that it needs to make better the accuracy of payments to Medicare Advantage policies that serve vulnerable populations, like dually eligible or low income beneficiaries, by adjusting star ratings to depict the enrollee’s socioeconomic and/or disability status.
The percentage of Medicare Advantage enrollees in 4- or 5-star contracts has nearly quadrupled since the year 2009 to 71%.
About one-third of prescription drug policy enrollees are in Part D plans with 4 or more stars, in comparison to 27% of enrollees in such plans in the year 2009, CMS claimed
CMS is also searching to revise how they risk adjust payments to policies, to more accurately depict the cost of care for dually eligible beneficiaries.
Enrollment and quality have grown in the Medicare Advantage and Part D since enactment of the Affordable Care Act, CMS stated. Medicare Advantage has reached record high enrollment each year since the year 2010, a trend sustaining in the year 2016 with a cumulative increase of 50%.
More than seventeen million beneficiaries are enrolled, representing almost 32% of all Medicare beneficiaries.
Average Medicare Advantage premiums have fallen by almost 10% from the time period of 2010 to 2016, CMS stated.
If finalized, CMS claimed, the rules will offer stable and fair payments to policies, and make unprecedented betterments to the program for plans that give high quality care to the most susceptible enrollees.
“These proposals susatin to keep Medicare Advantage powerful and stable and as with this past year, support the provision of high quality, affordable care to seniors and persons living with disabilities,” stated CMS Acting Administrator Andy Slavitt. “In specific, these proposals support investment in dually Medicare-Medicaid eligible individuals and those with complicated socioeconomic requirements.”
The proposed rate notice of Friday kicks off 45 days of feedback before the final year 2017 rates are issued on the day of April 4.
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