CMS published its final Medicare Advantage rate notice for 2024 on March 31, moving ahead with changes to risk adjustment payments but phasing in the model over three years.
Because the changes will be phased in over three years, the agency said Medicare Advantage plans will see an average payment increase of 3.32 percent between 2023 and 2024, up from 1.03 percent in the advance notice.
Here is what six industry leaders said about the policy:
Matt Eyles, president and CEO of AHIP, said the association appreciates CMS' decision to phase in rate changes over time.
"A large bipartisan group of Congressional champions and other stakeholders stepped forward to demonstrate their strong support for beneficiaries and this program, which consistently delivers affordable, high-quality care to millions of Americans. We applaud these leaders for standing up for seniors and people with disabilities," Mr. Eyles said.
Mary Beth Donahue, president and CEO of the Better Medicare Alliance, said the alliance appreciated the phased in-approach but said the "underlying policy is fundamentally unchanged."
"We remain concerned about the unintended consequences for seniors of this risk adjustment policy," Ms. Donahue said.
The Alliance of Community Health Plans said it supported the risk adjustment changes, which address incentives to "aggressively document" codes.
"CMS has taken a significant step towards the goal of aligning incentives for documenting diagnosis codes with those clinical conditions most predictive of future health care spending," the alliance said in a statement.
The Special Needs Plan Alliance said it was "pleased" with CMS' decision to phase in the adjustment over three years but is still concerned about possible impacts to special needs MA plans.
"We do hope that CMS will use this two-year delay before the full impact of the 2024
model is in place to study the actual impact on these plans," the alliance said in a statement. "Due to SNPs enrolling beneficiaries with the highest level of chronic conditions and complex care needs, the impact of the Final Rate Notice is negatively and disproportionately impacting these high-risk beneficiaries and the plans who serve them."
Gen Gillespie, chief revenue officer at Belong Health, which consults with regional Medicare Advantage and dual-eligible plans, said some plans will likely cut benefits as a result of the rate notice, but the impact will vary greatly plan-by-plan.
"Probably not all Medicare members are going to see a benefit cut, but some definitely will," Mr. Gillespie told Becker's. "The other thing that we can expect is some plans may exit some of these products, which means fewer consumer options for them to enroll in. That's probably going to be market and plan specific. To be fair, this happens every year. New options come into the market, and some options that are no longer viable exit."
Mark Miller, PhD, executive vice president of healthcare at Arnold Ventures, told Becker's insurers claims that the rate notice will lead to a cut in benefits or rise in premiums is likely a "hollow threat."
"If any plan decides that they're going to aggressively reduce their benefits and increase their premiums, my suspicion is there's other plans that will be happy to take their market share away from them," Dr. Miller said. "I think it's mostly an empty threat, and to the extent that a plan decides to follow through on it, they're going to lose market share."