CMS Releases Medicare Advantage Advance Notice
The Centers for Medicare and Medicaid Services (CMS) has released the Calendar Year (CY) 2024 Advance Notice of Methodological Changes for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies. CMS will accept comments on the CY 2024 Advance Notice through March 3rd, with the final Rate Announcement to be published by April 3, 2023.
The Advance Notice proposes updates to MA payment growth rates and changes to the MA and Part D payment methodologies. These proposals include technical updates to the MA risk adjustment model to keep the model up to date and improve payment accuracy, such as by fully transitioning to the Internal Classification of Diseases (ICD)-10 system from ICD-9 for diagnosis coding in 2024. In addition, CMS is seeking comment on MA quality measurement under Part C Star Ratings as part of CMS’s overarching efforts to align quality measures across federal programs and with private payers, reduce burden, and improve the effectiveness of quality programs.
When the Effective Growth Rate of 2.09 percent is netted against a 3.3 percent risk score trend and negative adjustments for changes in star ratings and the anticipated impact of revisions to the risk model, CMS predicts an average increase of 1.03 percent in capitation rates for 2024.
A fact sheet outlining the proposal is available here, and the Advance Notice itself is here.
Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841