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Morning Briefing

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Thursday, Feb 3 2022

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CMS Eyes 8% Hike In Payments To Medicare Advantage Providers Next Year

The proposed adjustment in 2023 payments would be to address the financial impacts of social determinants of health and health equity in Medicare Advantage plans.

The Centers for Medicare and Medicaid Services on Wednesday proposed increasing Medicare Advantage payment by 7.98% in 2023 as they eye future changes to its risk adjustment model. In a proposed payment policy for 2023, the agency asked for feedback on whether MA's risk adjustment model and star ratings could address the impacts of social determinants of health and health equity. Medicare Advantage organizations could see an almost 8% increase in revenue next year compared to 2022, according to the proposed changes. The proposed increase is almost double the 4.08% pay increase plans saw for 2022. (Goldman, 2/2)

In other news about Medicare Advantage 鈥

Humana will cut nearly $1 billion from its business after increased competition led the insurer to lose half the new Medicare Advantage members it expected to gain during open enrollment. The nation's second-largest Medicare Advantage carrier will invest in automation to more efficiently run its business, increase commissions paid to outside sales reps, grow its home health and primary care services and cut non-essential business lines, including axing some portions of its real estate and its hospice business, said President and CEO Bruce Broussard. (Tepper, 2/2)

In more Medicare news 鈥

Gov. Charlie Baker wants to expand Medicare coverage for low-income seniors as part of his proposed spending package for the next fiscal year. The plan calls for expanding the state鈥檚 Medicare Savings Program 鈥 which pays a portion of premiums and deductibles 鈥 to include individuals who are 65 years and older, and whose income doesn鈥檛 exceed 200% of the federal poverty level. The state鈥檚 current limit is 165% of the federal poverty level. (Wade, 2/2)

Kingston Healthcare Center鈥檚 future is in jeopardy due to multiple health violations. The California State Medical Agency issued a notice to the nursing home Wednesday that its Medicare and Medicaid Services agreement will be terminated by the Secretary of Human Services effective Feb. 6. (Salzano, 2/2)

The pandemic has made staffing at nursing homes even more challenging. But for the first time, it's easier for people in the U.S. to find out what staff turnover is like at nursing homes in their area. Medicare is now posting those details on its Care Compare website. Visitors can select a particular nursing home and then click to view staffing information. (2/2)

Some people are enrolled in Part A already, but for whatever reason aren鈥檛 enrolled in Part B. So how do you go about getting enrolled in Medicare Part B in you鈥檙e already in Part A? (2/2)

Being proactive about your healthcare coverage doesn鈥檛 end after enrollment. Now is the time to learn about your Medicare plan and how to optimize the benefits.聽鈥淩eally be proactive as it comes to your preventative services,鈥 said Dr. Dinelli Monson, Chief Medical Officer, UnitedHealthcare Medicare & Retirement of Washington. 鈥淕et your colonoscopy, mammograms and other vital services you can get to maximize your benefit.鈥 (Hanson, 2/1)

In Medicaid news 鈥

When Melissa Bernardin of Concord applied for Medicaid coverage for the first time during the COVID-19 pandemic, she said the application process was confusing and difficult. She expected it would take her around 30 minutes. 鈥淚t took three hours,鈥 Bernardin said. Despite applying for an income-based program, she said she needed to provide unexpected documentation like the amount of savings in her retirement account and debt she owed on her cars. A spokesperson for the New Hampshire Department of Health and Human Services says someone applying for an income-based program should not have to provide the department with asset information. (Fam, 2/3)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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