Apr 8, 2019 | Medicare Advantage, Part D, Payers
CMS finalized 2020 rate updates for Medicare Advantage (MA) and other policies for MA and Part D benefit offerings. The final MA rates are expected to increase plan revenue by +2.53%, up from +1.59% in the proposed rates, with an additional +3.3% revenue expected due to plan coding behavior. This brief discusses the rate updates as well as finalized policy changes to MA and the Part D program. Click to read more.
Apr 3, 2019 | Hospice, MedPAC
MedPAC released its annual recommendations to Congress on Medicare rates and other policies. The Congressional advisory agency recommended a -2% update for Medicare payments to hospice in 2020, based on across-the-board positive indicators of current payment adequacy. Congress is unlikely to act on this recommendation in the near term, and even in the long term, Congress is unlikely to pass a negative update to hospice, given widespread support for the benefit. Click to read more.
Mar 28, 2019 | Air, Ambulance
Last year, Congress directed the GAO to write a report on air ambulance services. The report found that in 2017, 69% of commercial claims for air ambulance transports were out-of-network (OON). While the path to passing legislation that addresses issues such as OON and/or balance billing practices will be difficult, this GAO report will be used in the ongoing efforts by lawmakers in Washington. Click to read more.
Mar 27, 2019 | Medicare Advantage, MedPAC, Payers
Medicare Advantage enrollment continues to grow, in absolute numbers and as a percentage of Medicare beneficiaries, and is also becoming more concentrated in a few top MA organizations. MedPAC explores this growth, as well as notes issues with CMS’s quality measures for the star ratings program and the widening gap between MA costs to provide care and fee-for-service Medicare spending in the same geography. Click to read more.
