The Centers for Medicare & Medicaid’s plan to create more options for the Medicare Advantage program through payment changes is being encouraged by the nation’s largest nursing home association.
The agency in early February announced it is forecasting a nearly 8% increase in revenue for Medicare Advantage plans next year after releasing its 2023 advance notice. The agency expects proposed policy changes, including many targeted at improving health equity, will result in a 7.98% revenue increase for Medicare Advantage organizations.
The hope is that through the policy changes it will “create more choices and provide affordable options for consumers that meet their unique health needs,” CMS said.
“Through MA plans, patients have access to enhanced primary care in these underserved areas,” Mark Parkinson, president and CEO of the American Health Care Association/National Center for Assisted Living, said in a statement Friday. “We encourage CMS to take steps to expand beneficiary access to locally committed, specialized plans that meet the unique needs of a medically frail population.”
The group also applauded CMS’ support of provider-led initiatives, like MA special needs plans (I-SNPs).
“Provider-led I-SNPs account for 36 percent of all I-SNP plans, and they provide residents and patients on-site enhanced primary care and help prevent hospitalizations, resulting in higher quality care, as well as improved patient outcomes and satisfaction,” Parkinson said.
Medicare Advantage enrollment penetration currently exceeds 40% of beneficiaries nationally. That has made it increasingly important for post-acute providers to understand how Medicare Advantage plans are paid and to be able work with the managed care plans to help them improve their risk scores, one expert previously said.
“In return, post-acute providers need adequate payment and minimal administrative hassles so that they can provide quality care and retain their workforce,” said Brian Ellsworth, vice president for public policy and payment transformation for Health Dimensions Group.
