- On Monday, CMS revealed the 2017 capitation rates for Medicare Advantage (MA), which turned out to be lower than the agency had initially proposed last month due to "technical updates in the risk adjustment normalization factor."
- The average revenue is expected to be increased by about 0.85% from 2016 -- not including the coding acuity expected growth -- compared with the 1.35% rate the agency had proposed. Overall reimbursement is expected to go up by 3.05%.
- The updates are designed to improve payment accuracy by taking into account the socioeconomic and disability status of plans' enrollees.
CMS will implement an adjustment to its Star Ratings system, which was created to evaluate insurers' performance and track the costs associated with providing care to enrollees as well as account for low-income subsidy, dual eligible and/or disability status.
"We continue to strengthen Medicare Advantage and Medicare Part D, in particular for enrollees who need additional investments in their health, such as dually Medicare-Medicaid eligible individuals and those with complex socioeconomic needs," CMS acting Administrator Andy Slavitt said in a prepared statement.
"With these policies, we will continue to see improvements in growth, affordability, benefits, and quality for millions of seniors and people living with disabilities," Slavitt added.
Earlier this month, Humana CEO Bruce Broussard touted the benefits of MA in an op-ed, saying it puts health plans and providers on a single mission to improve health and well-being, Healthcare Dive previously reported.
In 2015, for the first time, more than 17.1 million (about 32%) of Medicare beneficiaries were enrolled in a MA plan, according to a CMS fact sheet. Enrollement in the plan increased by more than 50% since the ACA.
Other MA trends include:
- The percentage of enrollees in four or five star plans has nearly quadrupled to 71%;
- Plan premiums, on average, have dropped about 10% between 2010 and 2016.
Also beginning in 2017, CMS will phase-in an alternative payment policy for Medicare Employer Retiree Plans over the course of two years, according to the announcement.