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Experience. Integrity. Advocacy.

Medicare Advantage Rates for FY 2016 Finalized

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Insurance plans serving Medicare beneficiaries through the Centers for Medicare & Medicaid Services’ (CMS) Medicare Advantage (MA) program will receive an increase in payments averaging 1.25 percent for fiscal year 2016, according to a CMS announcement earlier this week.

The final revenue increase is larger than the .95 percent cut previously announced in February’s advance notice. Officials say the difference is largely due to recently updated Medicare per capita spending estimates for 2014 and 2015. According to those figures, Medicare per capita spending in 2014, 2015, and 2016 is still expected to be below historical standards.

Medicare Advantage has reached record high enrollment each year since 2010, a trend continuing in 2015 with a cumulative increase of more than 40 percent since 2010. At the same time, premiums have fallen by nearly 6 percent from 2010 to 2015. And, more than 90 percent of Medicare beneficiaries have access to a $0 premium Medicare Advantage plan.

CMS reported that the finalized policies reflect the many comments received during the public comment period. Among their goals outlined in the announcement, CMS hopes to ensure that plan sponsors have the right incentives to care for dual eligible populations over the long term, to emphasize quality care and value-based payment models, and to provide enrollees with greater information to make informed and timely decisions about their care and their coverage. The last provision requires Medicare Advantage plans to maintain accurate provider directories in a timely manner and make those directories widely available to plan members.

For more information about the payment increase and other policy changes, review the Moving Medicare Advantage and Part D Forward Fact Sheet.

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Charity Singleton Craig

Charity Singleton Craig is a freelance writer and editor who provides communications and marketing services for CIPROMS. She is responsible for creating, editing, and managing all content, design, and interaction on the company website and social media channels in order to promote CIPROMS as a thought leader in healthcare billing and management.

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