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CMS finalizes 2016 Medicare Advantage payment rates: 10 things to know

Submitted by Anonymous on Thu, 04/23/2015 - 12:21


  1. Suggested health insurers offering Medicare Advantage plans would see their rates cut by approximately 0.95 percent in 2016
  2. Health insurers will see Medicare Advantage payment rates go up 3.25 percent on average after expected growth in plan risk scores
  3. The rate increase was based on a higher estimate of traditional Medicare spending and does not stem from a change in policy
  4. UnitedHealth — the top provider of Medicare Advantage plans last year — stands to get the biggest revenue boost from the increased rates
  5. CMS announced the star rating system used to assess the quality performance of plans will be updated in 2016 to "strengthen the accuracy of the evaluation system."
  6. Insurers will be required to take steps to ensure their physician and provider directories are up-to-date
  7. CMS will begin working with insurers offering MA plans to collect information on their adoption of value-based payment models
  8. Medicare Advantage enrollment has increased by 42 percent since the passage of the Patient Protection and Affordable Care Act in 2010
  9. The finalized policies will continue to strengthen the growing MA program, and continue the successful implementation of the ACA's reforms
  10. The changes will help align the MA program with the HHS goal of having 30 percent of Medicare payments based on how well patients are cared for in 2016


Source: CMS
Source URL: http://www.beckershospitalreview.com/finance/cms-finalizes-2...



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