On April 3, the Centers for Medicare & Medicaid Services
(CMS) released its 2018 Medicare Advantage and Part D rate
policies. In its press release, CMS noted, "On average,
plans can expect a revenue change of 0.45 percent, though
individual experiences will vary. When accounting for the expected
growth in coding acuity, plans can expect a total change of 2.95
percent in revenue. Plans that improve the quality of care they
deliver to enrollees will see higher updates and can grow and
enhance the benefits they offer to enrollees."
CMS also released updated Medicare Advantage and Part D policies to
provide organizations with additional flexibility and incentives.
CMS hopes to encourage the development of new plan offerings with
innovative provider network arrangements that may further encourage
enrollee use of, and improve access to, high-quality healthcare
services.
Based on industry feedback, CMS adjusted the phase-in of the use of
encounter data for calculating the risk score from the proposed 25%
to 15% for 2018. The use of encounter data is described in
CMS's fact sheet.
In addition to the payment and policy updates, CMS released a
Request for Information for continued feedback on Medicare
Advantage and Part D. CMS is soliciting ideas for regulatory,
sub-regulatory, policy, practice and procedural changes to better
accomplish transparency, flexibility, program simplification and
innovation in Medicare Advantage and Part D. Comments on the
Request for Information will be accepted through April 24 at
the email address given in Attachment 1 to this document.
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