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CMS Boosts Medicare Advantage Rates, Adjusts Risk Score Calculations Despite Concerns

from FierceHealthcare

Medicare Advantage plans will see a 3.4 percent payment boost next year, much higher than the 1.84 percent increase originally proposed by the White House in February. A final rule issued by the Centers for Medicare & Medicaid Services (CMS) also altered the way it calculates Medicare Advantage risk scores, increasing the portion of encounter data from 15 percent to 25 percent for 2019. The remaining 75 percent will be based on fee-for-service data. The agency defended the move by saying the quality of encounter data has improved. more


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