The Centers for Medicare and Medicaid Services (CMS) recently announced that Accountable Care Organizations (ACOs) saved Medicare $739.4 million in 2018, up from $314 million in savings the year before. Those savings were achieved despite policies that Rooke-Ley and colleagues argue in a recent Health Affairs Blog post disadvantage ACOs relative to Medicare Advantage (MA) plans. Their analysis concludes that ACOs cut costs…
The Medicare Advantage (MA) program, which allows Medicare beneficiaries to voluntarily enroll in a private plan that administers health benefits, was established by the Balanced Budget Act (BBA) of 1997 as a vehicle to bring private-sector competition and innovation to Medicare beneficiaries. When the program was announced, the goal was to create greater competition on…
Medicare Advantage insurers added 1.4 million members to their rosters for 2019 coverage, as they looked to grow membership in a market known for being politically safe and predictably lucrative. But Advantage membership is growing at slower pace compared with previous years. According to the latest federal data showing enrollment as of this month, 22.4…
Medicare Advantage is a growing market and an attractive opportunity for payers to offer quality plans to older beneficiaries. Competition is increasing in the MA environment, and beneficiaries have more options than ever to meet their coverage needs. With more choice comes higher rates of disenrollment as members select the most valuable plans for their…
CMS recently announced that it advanced a demonstration that would waive Merit-Based Incentive Payment System (MIPS) requirements for eligible clinicians participating in at-risk Medicare Advantage plans. If approved, the Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) demonstration would apply to eligible clinicians sufficiently involved in Medicare Advantage plans that resemble Advanced Alternative Payment Models (Advanced…
Payers will now be able to work with companies like Uber or Lyft to provide transportation, for example, as part of a more complete set of benefits for the quickly growing MA population. CMS issued a final rule in May giving MA plans more flexibility in determining the types of supplemental benefits they can offer chronically…
Payers striving to compete in the Medicare Advantage (MA) market can add more value to their health plans by taking advantage of regulatory changes established under a new final rule. Starting in plan year 2019, payers can offer a greater variety of Medicare Advantage plans with more variation of health benefits, specialized cost-sharing designs, and…
The movement to value-based care is alive and well, with the Trump administration eager to put their own stamp on the program. In one of his first major speeches as Secretary of Health and Human Services, Alex Azar said value-based care “needs to accelerate dramatically.” This reprises the administration’s draft 2018–2022 strategic plan for HHS…
The federal government on Thursday proposed a 1.84% average rate increase for Medicare Advantage plans in 2019, along with other policy tweaks that officials said are designed to strengthen the MA and Medicare Part D programs. The rate increase is a good deal higher than the 0.45% increase the agency approved for 2018. However, it…
CMS should work to align quality and performance standards across all Medicare programs, including Medicare Advantage (MA) and the Medicare accountable care organization (ACO) initiatives, says AMGA. In a letter issued in response to proposed changes to MA and Medicare Part D, AMGA President and CEO Jerry Penso, MD, MBA, argued that more standardization across…