CMS Proposes Medicare Advantage Cuts

Medicare is proposing a small cut in Medicare Advantage rates for 2015, less than half of what private insurers were expecting from the federal agency. The final rule will be released April 7.
Published Online: February 24, 2014
Medicare is proposing a small cut in Medicare Advantage rates for 2015, less than half of what private insurers were expecting from the federal agency. The final rule will be released April 7.

The CMS based its projections (PDF), which will differ across the country based on a variety of factors, on an expected 3.55% decline in the Medicare Advantage growth rate factor and an expected decline of 1.65% in per capita expenditures in the fee-for-service portion of the senior citizen healthcare program. More than 15 million or 30% of all Medicare beneficiaries are currently in Medicare Advantage plans offered by private insurers. The CMS estimates that the blended rate of per capita spending for Medicare Advantage beneficiaries will decline by 1.9% in 2015.

“This historically low growth in Medicare per-capita spending is tied, in part, to successful initiatives undertaken to promote value over volume and help curb fraud, waste and abuse in the Medicare fee-for-service program in recent years,” the agency said in a press release.

Read the full story here: http://bit.ly/1hpeXmu

Source: Modern Healthcare

Feature
Recommended Articles
The deal combines Humana's 3.2 million Medicare enrollees with Aetna's 1.26 million Medicare enrollees, giving the new combined company a strong position as the baby boomer population ages.
As co-pays and deductibles in Medicare and commercial health plans become more prevalent, so, too, does the temptation to waive them. But beware.
In addition to increasing insurance coverage, the Affordable Care Act also aims to improve population health and lower healthcare costs. However, not much attention has been paid to the quality of care the newly insured are receiving.
New delivery models related to the recent healthcare reform legislation may help drive up utilization, as discussed by Francois de Brantes, MS, MBA; Ateev Mehrotra, MD, MPH; and Arthur Vercillo, MD, FACS, in this seventh segment of the Healthcare Reform Stakeholders Summit, Spring 2015 series. They theorize that healthcare convenience and availability may actually lead to a loss in coordination of care.
In this seventh segment of the Healthcare Reform Stakeholders Summit, Spring 2015 series, Francois de Brantes, MS, MBA, and Arthur Vercillo, MD, FACS, discussed a number of issues related to pricing transparency, including access to information, decreased pricing variability, and antitrust concerns.