CMS Signals That Medicare Advantage Payments Will Decline In 2024
The Centers for Medicare and Medicaid Services previewed Wednesday its 2024 payments and rates for Medicare Advantage. While a rate increase is proposed, insurers could see an average 2.3% cut to baseline payments, Stat reports. The agency also released planned changes to Medicare Part D and the star ratings programs.
Medicare Advantage insurers could face an average 2.3% cut to baseline payments in 2024, the Biden administration said Wednesday. If the proposal stands, it would be a net cut of more than $3 billion to the industry. The major reason behind the proposed pay cut: Medicare officials want to update data and coding systems that are used to explain the health conditions of an insurance company鈥檚 enrollees. Under that new system, insurers would not get paid as much for members with certain diagnoses. (Herman, 2/1)
Medicare Advantage rates will rise by 2.09% next year, in line with expectations, the Centers for Medicare and Medicaid Services announced in a notice published Wednesday. The advance notice includes a number of provisions, such as revisions to Medicare Advantage risk-adjustment and changes to the star ratings programs for Medicare Advantage and Medicare Part D. CMS also laid out its plan to implement provisions from the Inflation Reduction Act of 2022. (Berryman, 2/1)
Medicare Advantage plans are expected to receive a 1.03% increase in revenue under the 2024 Advance Notice for the Medicare Advantage and Part D Prescription Drug Programs released by the Centers for Medicare and Medicaid Services on Wednesday.聽CMS is proposing technical updates to the MA risk adjustment model by fully transitioning to the Internal Classification of Diseases from ICD-9 to ICD-10. The latter has been in use since 2015. It also updates underlying fee-for-service data years from 2014 diagnoses and 2015 expenditures to 2018 diagnoses and 2019 expenditures. (Morse, 2/1)
In updates on the debt ceiling talks 鈥
Speaker Kevin McCarthy left his first White House visit with confidence that he and President Joe Biden could negotiate a spending deal, but the real test may come in negotiations with his own Republican conference.聽McCarthy, who had to bargain with hardline conservatives to win his speaker bid after 15 rounds of voting, leads a fractious caucus where some members are willing to gamble with the nation's credit score and global economy to try and get聽the federal spending cuts they want.聽But what those cuts are, nobody seems to know.聽(Woodall, 2/1)
Sen. Josh Hawley introduced a bill Wednesday to prevent Congress from using Social Security and Medicare as a tool in negotiations over the debt ceiling, as some members of his party have talked about making changes to the programs. 鈥淭hese are key programs that, frankly, every American relies on,鈥 said Hawley, a Missouri Republican. 鈥淭hey pay into it and every American expects when they retire, that they will be able to collect that Social Security benefit they paid into and also the Medicare health care benefit that they had paid into.鈥 (Desrochers, 2/1)
In other Medicare news 鈥
Humana Inc. said it needs more details to gauge the impact of a new Medicare policy that threatens to claw back billions from health insurers, but investors have decided it鈥檚 not nearly as bad as they feared. (Tozzi, 2/1)
Humana said its individual enrollment in Medicare Advantage plans would jump by 鈥渁t least 625,000鈥 for 2023 in what is becoming a banner year for the popular privatized health insurance for U.S. seniors. The projection for Medicare Advantage growth was included in Humana鈥檚 fourth quarter earnings report released Wednesday that included a $15 million loss thanks in part to costs of investments made last year to improve its health plan operations. Revenues rose to $22.4 billion in the fourth quarter on Medicare Advantage growth and higher premiums compared to $21 billion in the year-ago period. (Japsen, 2/1)
A new year means changes to Medicare, including updated premiums and deductibles and sometimes big policy moves. In 2023, there鈥檚 a little of everything: Some costs have gone down, others have increased, and there are some notable tweaks to how Medicare works. Understanding what鈥檚 new can help you get the most from your Medicare benefits. Here are some key 2023 updates, according to the Centers for Medicare & Medicaid Services. (Ashford, 2/2)