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Medicare Advantage to receive 1.25% pay bump in 2016

April 6, 2015
by Pamela Tabar, Editor-in-Chief
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The Medicare Advantage program will be getting a reimbursement raise in 2016 after all, according to the final rate changes released today by the Centers for Medicare & Medicaid Services (CMS).

Although rates will differ among Medicare Advantage (MA) plans, the average rate increase is expected to be 1.25 percent, higher than the rate adjustment predicted in February. As always, the rates are geared to “move payments towards aligning MA program payments with payments made for beneficiaries in fee-for-service Medicare,” noted a CMS fact sheet.

The final rate announcement and call letter also outlined CMS’ initiatives concerning value-based provider payment models, cost-sharing pharmacies, a revised star ratings system and better accuracy in network provider directories. All initiatives are centered on improving quality, providing more information for enrollees and embracing payment reform, CMS said.

The MA programs have seen record-breaking enrollment each year since 2010, and premiums have fallen during the same time, CMS noted. Nearly one-third of Medicare beneficiaries are enrolled in a MA plan.

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