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2018 Medicare Part C and D Rate Updates Released; CMS Solicits Additional Feedback by April 24

Posted in Legislation and Public Policy, Medicare and Medicaid, Private Insurers, Reimbursement Matters

On April 3, the Centers for Medicare & Medicaid Services (CMS) released its 2018 Medicare Advantage and Part D rate policies. In its press release, CMS noted, “On average, plans can expect a revenue change of 0.45 percent, though individual experiences will vary. When accounting for the expected growth in coding acuity, plans can expect a total change of 2.95 percent in revenue. Plans that improve the quality of care they deliver to enrollees will see higher updates and can grow and enhance the benefits they offer to enrollees.”

CMS also released updated Medicare Advantage and Part D policies to provide organizations with additional flexibility and incentives. CMS hopes to encourage the development of new plan offerings with innovative provider network arrangements that may further encourage enrollee use of, and improve access to, high-quality healthcare services.

Based on industry feedback, CMS adjusted the phase-in of the use of encounter data for calculating the risk score from the proposed 25% to 15% for 2018. The use of encounter data is described in CMS’s fact sheet.

In addition to the payment and policy updates, CMS released a Request for Information for continued feedback on Medicare Advantage and Part D. CMS is soliciting ideas for regulatory, sub-regulatory, policy, practice and procedural changes to better accomplish transparency, flexibility, program simplification and innovation in Medicare Advantage and Part D. Comments on the Request for Information will be accepted through April 24 at the email address given in Attachment 1 to this document.

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