Medicare Advantage Programs
Expert articles and analysis related to medicare advantage programs.
AI Summary — Last 30 Days
In the past 30 days, significant developments in the Medicare Advantage (MA) landscape reflect a shift in regulatory focus under the Trump administration, particularly from a new committee tasked with enhancing MA sustainability by modernizing risk adjustment and quality measurement processes. This comes amid controversy over CMS's proposal to maintain flat MA rates for the next year and alter risk adjustment calculations, eliciting widespread feedback from insurers concerned about potential financial implications (CMS receives record comments). Concurrently, enrollment in Special Needs Plans has surged by 23% over the past two years, highlighting both an increasing acceptance of MA plans among beneficiaries and the need for providers managing this risk to adapt strategically to these evolving trends (MA Enrollment, the SNP Acceleration).
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The Trump administration wants to keep MA rates flat next year and change how risk adjustment is calculated. Insurers had a lot to say about this, CMS officials shared Tuesday during an event in D.C.
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Federal regulators are planning to suspend enrollment in Elevance's MA plans at the end of March, in a rare and serious threat to the company’s finances.
Considerations for implementing Medicare Advantage encounter data in risk adjustment - MedPAC (.gov)
Considerations for implementing Medicare Advantage encounter data in risk adjustment MedPAC (.gov)