Medicare Advantage in the headlines: 5 recent updates

CMS has published its final rates and rules for Medicare Advantage in 2025. Payers say the new rate payments are putting more pressure on already strained margins. 

Here are five key Medicare Advantage stories Becker's has reported since March:

  1. Rising medical cost trends in Medicare Advantage aren't going down, but they are stabilizing, UnitedHealth Group executives said.

    "We haven't seen a step-down from that trend, but we certainly see that kind of sustained activity without aggressive acceleration," CEO Andrew Witty said on an April 16 investor call.

  2. CMS issued its final 2025 Medicare Advantage and Part D rule April 4, setting new standards around marketing, broker payments and prior authorization. Here are 11 key updates to know.

  3. As Medicare Advantage enrollment climbs, the scene has been set for tensions between hospitals and payers to intensify. Chip Kahn, president and CEO of the Federation of American Hospitals, told Becker's, "The relationship between hospitals and managed care is strained at best right now."

    Kurt Barwis, CEO of Bristol (Conn.) Health, told Becker's the system is short millions in revenue as a result of delayed and denied payments from MA plans. In the past year, Bristol Health has received 13.8% less in payments from MA plans than from fee-for-service Medicare, according to Mr. Barwis.

  4. CMS finalized a slight 0.16% decrease in Medicare Advantage benchmark payments for 2025. The agency published its final rate notice for 2025 April 1. The agency estimates plans will see 3.7% higher-revenue overall in 2024. Payer executives called the rate a cut because it did not account for rising costs in the MA population.

    In its final rate notice, CMS said it was aware of reports that costs are increasing but said it was "not aware of all of the specific drivers accounting for the experience of these MA organizations."

  5. Zing Health, a Medicare Advantage insurer facing termination of one of its contracts from the program, sued CMS over the methodology it uses to calculate star ratings. In a lawsuit filed March 25, the Chicago-based insurer alleged CMS made a "serious error" in calculating its star ratings.   

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