Dive Brief:
- The Centers for Medicare and Medicaid Services announced late Friday afternoon that it would seek a 0.95% rate cut to the Medicare Advantage program in 2016—which as a result of "expected growth in plan risk scores due to coding," would translate to an average increase in revenue of 1.05%.
- Medicare Advantage enrollment has grown by more than 40% since the ACA passed,with premium costs declining around 6%.
- Comments are due by March 6, with final rates to be released April 6.
Dive Insight:
Encouraging news for MA plan issuers, but these are still average figures. Geography and five-star ratings, among other things, will have a big impact on whether an individual MA plan will receive a cut or a raise. In 2016, plans that earn at least four stars will earn a 5% bonus payment, but 3.5 stars or fewer will receive no additional payments.
CMS also revealed in the announcement that it will transition wholly to a widely-opposed new risk-adjustment methodology. The agency also said that it will not propose any adjustments to the use of home visits for the purposes of patient risk assessments.