Insurer payments to climb 3.4% under new Medicare Advantage rule: 3 notes


CMS will up payments it makes to Medicare Advantage insurers by 3.4 percent in 2019 — almost two times the amount it previously proposed.

Here are three things to know from CMS' April 2 2019 Rate Announcement.

1. At the beginning of February 2018, CMS proposed raising Medicare Advantage plan payments by an average 1.84 percent in 2019.

2. CMS noted the final 3.4 percent payment increase doesn't reflect adjustments for coding trends. When included, CMS estimates the coding trend will increase risk scores by an average 3.1 percent.

3. CMS is finalizing proposed changes to the Medicare Advantage risk adjustment model for 2019. The adjustment will add mental health, substance use disorder and chronic kidney disease conditions, among others, to the model.

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