The 8.5% boost in average revenue slated for Medicare Advantage plans in 2023 is proof of the Centers for Medicare & Medicaid Services support of the program and could mean improved payment for post-acute care providers who take advantage, an expert suggested.
CMS on Monday finalized its 2023 Medicare Advantage and Part D pay rates with an effective growth rate of 4.88% for MA plan payments and will result in the 8.5% pay increase.
That’s higher than the 4.75% growth rate and 7.98% increase in average revenue the agency predicted for the plans in its advance notice, which was issued in early February.
“CMS has sent a clear signal about its support for the Medicare Advantage program” with the increase, Brian Ellsworth, vice president for public policy and payment transformation for Health Dimensions Group, told McKnight’s Long-Term Care News on Tuesday.
“CMS will also continue the policy of risk adjusting payments to [MA] plans based on a combination of fee-for-service claims and encounter data,” he added.
Ellsworth explained that since MA enrollment penetration now exceeds 40% of beneficiaries nationally — and in some states, penetration is over 50% — these payment policy issues have an increasing effect on post-acute providers and vice versa.
“Those post-acute providers that are able to work with Medicare managed care plans to improve their risk scores will have a better argument for improved payment from those plans,” Ellsworth said. “The continued increases in [MA] penetration make forming effective relationships between post-acute and Medicare managed care imperative.”
The agency has previously said that these payment changes are part of its effort to create more choices and provide affordable options for consumers to meet their health needs.
“CMS’ goals for Medicare Advantage and Part D mirror our vision for the agency’s programs as a whole, which is to advance health equity; drive comprehensive, person-centered care; and promote affordability and the sustainability of the Medicare program,” agency officials wrote Monday.
The American Health Care Association in late March backed the payment changes that it said, in turn, helps provider-led initiatives, such as MA special needs plans (I-SNPs).