A Look Back at the Historic Ups and Downs of Medicare Advantage Payment Policies

April 6

Since the Feb. 1 release of the 2024 Advance Notice of Methodological Changes for Medicare Advantage Capitation Rates and Part D Payment Policies, MA insurers had been bracing for comprehensive risk adjustment changes that they argued would result in rate reductions, rather than the modest 1.03% improvement CMS had predicted. In its 2024 final rate notice, released on April 3, CMS finalized but chose to phase in changes to the risk adjustment model, leading to an average expected pay increase of 3.32%. This shift is not unique, as an exclusive look back at previous AIS Health coverage on previous rate notices shows that for much of the last decade, CMS has often left out certain unpalatable proposals from the Advance Notice and improved its payment forecasts.

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Radar on Medicare Advantage

Lauren Flynn Kelly Managing Editor, Radar on Medicare Advantage

Lauren has been covering health business issues since the early 2000s and specializes in in-depth reporting on Medicare Advantage, managed Medicaid and Medicare Part D. She also possesses a deep understanding of the complex world of pharmacy benefit management, having written AIS Health’s Radar on Drug Benefits from 2004 to 2005 and again from 2011 to 2016. In addition to her role as managing editor of Radar on Medicare Advantage, she oversees AIS Health’s publications and manages the health editorial staff. She graduated from Vassar College with a B.A. in English.