CMS finalizes Medicare Advantage rate cut: 5 things physicians should know 

CMS finalized a slight cut in Medicare Advantage benchmark payments for 2025, according to a final rate notice published April 1. 

Here are five notes:

1. CMS estimated plans will increase MA revenues by an average of 3.7%, or more than $16 billion, from 2024 to 2025.

2. The agency will cut benchmark payments by 0.16% from 2024 to 2025, a 0.2% decrease from the previous year and the same percentage the agency proposed in January.

3. The agency projected that its Medicare Advantage risk score trend of 3.86%, the average increase in adjustment payments year over year, will offset risk model revisions that will lead to a 2.45% decline in revenue and a projected decline in star rating bonuses.

4. CMS is projected to pay between $500 billion and $600 billion in MA payments to private health plans in 2025.

5. "These policies will put even more pressure on the benefits and premiums of 33 million Medicare Advantage beneficiaries who will be renewing their coverage this fall," AHIP President Mike Tuffin said in an April 1 news release. "It is important to note that the Medicare Advantage and Part D programs are already undergoing a number of significant regulatory and legislative changes. Moreover, the cost of caring for Medicare Advantage beneficiaries is steadily rising."

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Webinars

Featured Whitepapers

Featured Podcast