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2020 will be kind to Medicare Advantage

Posted by www.psmbrokerage.com Admin on Wed, Apr 03, 2019 @ 10:17 AM

2020 will be kind to med adv

By Sam Baker – Axios – April 2, 2019

The average payment rate from the federal government to companies that sell Medicare Advantage plans will go up 2.53% in 2020 — a sizable boost from what was
proposed in January, Axios' Bob Herman reports.

The big picture: Even though the 2020 pay increase isn't as generous as 2019's, health insurers will still benefit a lot from higher payments as well as other new, industry-friendly policies — like being able to cover meals and car rides to doctors' appointments, which could attract more seniors to these plans.

Yes, but: Against the industry's wishes, Medicare will change part of its process for calculating insurers' payments according to how sick their members are — known as a "risk score."

  • Currently, 75% of a patient's risk score is based on traditional medical data, and 25% is based on "encounter data" — a more complete dataset of a patient's conditions.
  • Insurers dislike encounter data because they say it's inaccurate.
  • But the system will be shifting to a 50/50 split by 2020.

But, but, but: All MA risk scores originally were supposed to be based 100% on encounter data by 2020, so insurers are still coming out ahead.

Source: https://www.axios.com/newsletters/axios-vitals-93c18d09-788d-495f-bdef-7c9cbd857039.html

Image: Freepik

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Tags: Medicare Advantage

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