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

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