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CMS Raises Medicare Advantage Payments

Posted on Friday, April 6, 2018 7:49 PM

CMS has finalized its 2019 Medicare Advantage rates, raising payments it pays to insurers.

Payments to Medicare Advantage will rise an average of 3.4%. That’s well above the 1.84% bump the agency initially proposed and higher than the 2.95% increase for 2018. The CMS is also moving forward with plans to increase the use of encounter data to determine risk scores for plans. As a result of the finalized rule, 75% of Medicare Advantage risk scores will be based on traditional fee-for-service data, and 25% based on encounter data. That differs from 2018, when the agency used a risk score blend of 85% fee-for-service data and 15% encounter data.

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