CMS Issues Key Changes to Ensure High-Quality Care
- By BSTQ Staff
The Centers for Medicare and Medicaid Services’ 2015 rate announcement and final call letter for Medicare Advantage and Part D programs implements several policies that will ensure beneficiaries have access to high-quality, high-value and low-cost options. There are four key updates for 2015: lower out-of-pocket prescription spending for Part D beneficiaries in the prescription drug “donut hole”; protection for Medicare Advantage beneficiaries from major cost increases or reduction in benefits through the Affordable Care Act; increased protection through established provider access and established best practices for beneficiaries affected by changes in Medicare Advantage plan networks; and payment adjustments to Medicare Advantage plans that include reducing excessive payments, basing part of Medicare payment on plan quality performance, and improving Part C payment scheduling and accuracy. Nearly 30 percent of Medicare beneficiaries are enrolled in a Medicare Advantage plan, and nearly half of enrollees are now in plans with a rating of four or more stars, a significant increase from 37 percent in 2013.
