CMS finalizes MA, Part D payment and policy changes for 2017

The Centers for Medicare & Medicaid Services late today announced final changes to the Medicare Advantage and Part D prescription drug programs for calendar year 2017, which will increase payment rates in aggregate by a net 0.85%. When combined with expected growth in plan risk scores, CMS anticipates the MA plans and Part D sponsors will see an average revenue increase of 3.05%. In addition, CMS finalized several notable policy changes, including modifications to the risk-adjustment model to more closely align reimbursement with costs for dually eligible beneficiaries and refinements to a subset of the Star Ratings program measures to account for beneficiary socioeconomic and disability status. CMS also made slight modifications to other policies, including a slower transition to the use of encounter data in calculating risk scores, a change for which AHA advocated. AHA members will receive a Special Bulletin tomorrow with further details.