Though insurers could see more money from CMS, headwinds are still challenging the industry. Here are eight Medicare Advantage updates Becker’s has reported since June 10.
- Data Medicare Advantage insurers provide to the federal government has become more complete in recent years, but gaps remain, according to MedPAC’s most recent annual report.
- The financial headwinds facing major Medicare Advantage carriers are also affecting companies across the Blue Cross Blue Shield system. BCBS Minnesota said its MA cost trends are affected by the same challenges felt across the industry, reporting a 40% decrease in operating profits from 2023.
- Elevance Health executives said the company is comfortable with its Medicare Advantage business as other insurers project losses. Stephen Tanal, vice president of investor relations at Elevance, said he is comfortable predicting “market-plus” growth for the company’s MA business in 2025.
- CMS recalculated Medicare Advantage plans’ star ratings after insurers challenging the agency’s methodology were handed court victories. In a letter to MA plans, CMS said it will revise star ratings for plans using 2023 cut points. CMS will not decrease any plan’s rating, according to the letter.
- A group of U.S. lawmakers introduced legislation aimed at reforming the Medicare Advantage prior authorization process. The legislation is an updated version of the Improving Seniors’ Timely Access to Care Act, which passed the House in 2022 but stalled in the Senate.
- Rather than look back to the early days of the traditional Medicare system, the next presidential administration should target a “major reboot” of the program, SCAN Group CEO Sachin Jain, MD, wrote in Forbes.
- Medicare Advantage enrollees spend more than $2,500 less on healthcare costs on average than traditional Medicare enrollees, according to an independent analysis by ATI Advisory.
- Humana’s challenge to a CMS rule implementing stricter auditing standards on Medicare Advantage plans can continue, a federal judge ruled.
