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Increment of 0.45% in Medicare Advantage payment rates

Apr 05, 2017

Increment of 0.45% in Medicare Advantage payment rates

The federal government has decided to improvise average pay increases for 2017 Medicare Advantage plans settling on a normal rate increment of 0.45% after at first proposing a 0.25% increase, and changed a few of the program's strategies for the health care insurance industry.

Seema Verma, the Centers for Medicare and Medicaid Services (CMS) Administrator announced that “Medicare is committed to strengthening Medicare Advantage and the Prescription Drug Program by supporting flexibility and efficiency.”

The CMS says the fresh and updated policies incorporated into the current year's rate declaration provide MA associations, the incentive to grow new plans offerings with "innovative provider network arrangements" that may additionally urge enrollees to access brilliant quality healthcare services.

Medicare Advantage payment rates depend on trends and usage in free service Medicare and in addition conformity to recipients risk scores, among different factors. In any case, CMS presently did not settle a fault points of confinement incentive expenses protection receive for giving high and good excellence care in Medical Advantage plans.

The CMS is similarly putting the brakes on plans to expand the utilization of encounter information, or data about the care got from a supplier, to decide risk scores for arrangements. In the proposed strategic plan it had recommended again utilizing the proportion set up in 2017. In that, 75% of Medicare Advantage risk scores depend on conventional free for service information and 25% depend on encounter information.

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