CMS Seeks to Level Member Playing Field Via Stars Changes

Aside from a headline-grabbing estimated pay boost of nearly 8% for Medicare Advantage organizations next year, the Biden administration’s first preliminary rate notice didn’t include many surprises for MA and Part D sponsors. Instead, the notice focused largely on potential changes to star ratings in the name of advancing health equity and monitoring member experience. At the same time, the notice addressed one aspect of payments for insurers serving a large portion of patients diagnosed with end-stage renal disease (ESRD) but left another to future policymaking.

“The release of the Advance Notice, coupled with the release of the proposed rule last month, marks an important milestone in the policy and rate setting process, and really represents the first major rate notice developed entirely under the Biden administration,” said Greg Gierer, vice president of policy and research, during a Feb. 9 webinar hosted by Better Medicare Alliance (BMA). Moreover, it “provide[s] an opportunity for the admin and CMS to really shape the program as the administration looks to advance important policy work on shared goals, including advancing health equity, improving the beneficiary experience, lowering out-of-pocket costs, and improving quality of care and health outcomes.”

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Lauren Flynn Kelly

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.

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