CMS Finalizes Medicare Advantage Pay Raise, Ups Encounter Data Use

Medicare Advantage plans are getting a pay raise and more flexibility to tailor benefits for chronically ill patients next year, the CMS said Monday. But Advantage plans’ payments will also be based on a higher percentage of patient “encounter data,” a change that health insurers have fought hard to avoid.

The CMS on Monday finalized a rule giving Medicare Advantage plans a 2.53% pay raise in 2020. The agency had initially floated giving plans a 1.59% pay bump for next year. The final rate is less than the 3.4% raise Advantage plans received for 2019, which was one of the biggest pay raises plans have received in years.

“These changes to the model better reflect costs and improve the financing for the care of beneficiaries with multiple conditions,” CMS Administrator Seema Verma said in a press call with reporters late Monday.

The final rule also allows Medicare Advantage plans more flexibility to offer supplemental benefits to patients with chronic illnesses…

Read More

Original article on Modern Healthcare by Shelby Livingston