By
Robert King and Shelby
Livingston | January 30, 2019
The CMS on Thursday proposed increasing the
baseline Medicare Advantage payment rates for 2020 by 1.59%, well below the
3.4% rate hike plans received in 2019.
The agency also outlined changes to the program to address the opioid crisis, including encouraging Medicare Advantage plans to offer targeted benefits and cost-sharing reductions to patients with chronic pain or undergoing addiction treatment.
The rate announcement is the second part of the 2020 Medicare Advantage Advance Notice. In the first part, released in December, the CMS proposed moving ahead with a plan to adjust payments to reflect the total number of conditions each patient has, in addition to viewing each condition individually in the risk adjustment model.
The CMS also had said it wants to increasing the amount of encounter data, or information about the care of an Advantage beneficiary received from a clinician, to determine risk scores for health plans.
The agency also outlined changes to the program to address the opioid crisis, including encouraging Medicare Advantage plans to offer targeted benefits and cost-sharing reductions to patients with chronic pain or undergoing addiction treatment.
The rate announcement is the second part of the 2020 Medicare Advantage Advance Notice. In the first part, released in December, the CMS proposed moving ahead with a plan to adjust payments to reflect the total number of conditions each patient has, in addition to viewing each condition individually in the risk adjustment model.
The CMS also had said it wants to increasing the amount of encounter data, or information about the care of an Advantage beneficiary received from a clinician, to determine risk scores for health plans.
Shelby
Livingston is an insurance reporter. Before joining Modern Healthcare in 2016,
she covered employee benefits at Business Insurance magazine. She has a master’s
degree in journalism from Northwestern University’s Medill School of Journalism
and a bachelor’s in English from Clemson University.
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