Dive Brief:
- Medicare Advantage plans had to file their 2015 actuarial bids with CMS on Monday, and in doing so, figure out how to handle federal payment rate cuts averaging 2% to 3% for next year.
- To make the math work for a second-straight financially challenging year, MA plans are making tough decisions about whether to increase premiums, slash benefits, trim provider networks and/or improve medical management.
- Details on 2015 Medicare plans won't be available officially until this fall, but industry consultants say some MA organizations are leaving the market or cutting back on service areas — though there will be some new plan entrants, too.
Dive Insight:
Whether some MA plans exit the 2015 market entirely or only leave certain service areas, hospitals could end up working with fewer carriers. Even if plans hang around, their members' inpatient copays likely will go up — a worrisome development for hospital administrators concerned about bad debt since beneficiaries don't always pay their portion of the bill.
In general, MA plans decided to increase members' 2015 copays, sometimes for inpatient care and also for hospital outpatient services. "It was a tough enough year that anything was on the table," industry actuary Pat Dunks of Milliman, Inc. told Healthcare Dive. According to Dunks, some MA plans also are introducing new benefit products with narrower provider networks, which signals a lot of potential movement in next year's market.
