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CMS announces final 2017 Medicare payment, policy updates
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CMS has released its final changes to the Medicare Advantage and Part D Prescription Drug Program for 2017, announcing new initiatives to improve payment accuracy and to help combat the overuse of opioids.
In a press release, CMS officials said the changes will “provide stable payments to plans” and make improvements to plans that provide health care to Medicare’s most vulnerable enrollees.
“We continue to strengthen Medicare Advantage and Medicare Part D, in particular for enrollees who need additional investments in their health, such as dually Medicare-Medicaid eligible individuals and those with complex socioeconomic needs,” Andy Slavitt, CMS acting administrator, said in a press release. “With these policies, we will continue to see improvements in growth, affordability, benefits and quality for millions of seniors and people living with disabilities.”
According to the press release, CMS’ final 2017 policy update includes several changes from the proposed plan initially introduced in February, made in response to feedback during the public comment period. The final update increases payments for the Medicare Advantage plans by an average of 0.85%. This represents a decrease from February, when CMS officials said the 2017 policy would include an average increase of 1.35%.
The expected average revenue change of 0.85% does not account for the expected growth in coding acuity, which has “typically added another 2.2%,” according to CMS. The change in the expected revenue increase is due to technical updates in the risk adjustment normalization factor, the press release said.
CMS stated the new growth rate remains consistent with last year’s update and reflects a similar pattern in Medicare fee-for-service.
New policies introduced in the 2017 update include a revised methodology used to risk-adjust payments to plans, which will more accurately reflect the cost of care for dually eligible enrollees, according to CMS. In addition, CMS plans to implement an interim adjustment to the Star Ratings to reflect the socioeconomic and disability status of beneficiaries.
CMS also plans to provide “much needed stability” to the Medicare Advantage program in Puerto Rico.
Seeking to help HHS in its goal of curbing the overuse of prescription opioids, CMS will also encourage safeguards before such treatments are dispensed at the pharmacy, and maintain access to needed medications.
“Today’s announcement drives improvements to payment for Medicare Advantage plans and continues to promote improvements in quality care for beneficiaries,” the press release stated. “Together, these changes will ensure the Medicare program remains strong and stable for current and future generations.”
Additional reading:
https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-04-04.html
https://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/Downloads/Announcement2017.pdf