CMS to Increase Medicare Advantage Pay Rate by 0.4%
- By BSTQ Staff
The Centers for Medicare and Medicaid Services (CMS) will increase the overall rate it pays Medicare Advantage plans by 0.4 percent in 2015, despite a proposed policy issued in February that signaled a 1.9 percent rate cut. The change is the result of “various policy changes” and “new estimates,” according to Jonathan Blum, former CMS principal deputy administrator. These include the administration’s approach to phasing in a new risk model and a decision to walk away from a proposal to require that home risk assessments be confirmed by in-office assessments. The Patient Protection and Affordable Care Act sought to bring the cost of Medicare Advantage more closely in line with traditional Medicare. Right now, Medicare Advantage plans are typically paid more than their traditional counterparts. “We are committed to the new model; however, for 2015, given the number of changes in other payment factors, we believe that providing a longer time frame for full implementation is appropriate,” said a CMS fact sheet.
There are currently more than 15 million seniors enrolled in Medicare Advantage. Beneficiaries enrolled in the plans, administered by private companies that contract with Medicare, account for approximately 30 percent of the total enrolled in Medicare.
