FOR IMMEDIATE RELEASE: February 11, 2016
FOR MORE INFORMATION: Jeff Van Ness, (202) 204-7515
STATEMENT OF ACAP CEO MARGARET A. MURRAY ON THE COMING
2017 ADVANCE NOTICE OF CHANGES TO MEDICARE ADVANTAGE
WASHINGTON—ACAP CEO Margaret A. Murray today made the following statement about the Advance Notice of Methodological Changes for Calendar Year 2017 for Medicare Advantage (MA) Capitation Rates, Part C and Part D Payment Policies and 2017 Call Letter (“Advance Notice”), which is expected to be issued by the Centers for Medicare & Medicaid Services (CMS) on February 19:
“The coming Advance Notice is a terrific opportunity for CMS to apply fixes to the ways it predicts costs for the poorest, sickest, and most vulnerable Medicare beneficiaries.
“This past fall, CMS acknowledged that its Medicare Advantage risk-adjustment system underpredicts the costs of full-benefit dual eligibles, or people who qualify for all Medicaid benefits owing to low incomes and poor health status. CMS proposed changes to the risk-adjustment model that would improve the accuracy of payments to plans that enroll these individuals.
“Safety Net Health Plans serve full-benefit dual eligibles and offer these individuals better coordinated care, access to care, and quality of care, than these individuals can receive in traditional Medicare.
“This single change is one of the most significant steps CMS can take to improve the accuracy of payments to such plans; until now, Safety Net Health Plans and others that have taken on serving the most challenging dual-eligible populations have been operating at a systematic, competitive disadvantage.
“Through the Advance Notice, CMS can work to level the playing field and make Medicare Advantage sustainable for plans serving full-benefit dual eligibles. We look forward to seeing provisions along the lines of those suggested in their fall memorandum and support CMS’s efforts to make Medicare Advantage rates fair and accurate for all health plans that participate.”
ACAP represents 57 not-for-profit Safety Net Health Plans, which provide health coverage to more than fifteen million people in 26 states. Safety Net Health Plans serve their members through Medicaid, Medicare, the Children’s Health Insurance Program (CHIP), the Marketplace and other health programs. For more information, visit www.communityplans.net.
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