The Medicare and Medicaid service centers recently announced that government payments to Medicare Advantage plans will increase by 5.06%, or $ 25 billion, from 2025 to 2026, which makes many defenders of the payers happy.
This is a significant difference with respect to the increase of 2.23% proposes the Biden administration in January. The increase is mainly due to the increase in the effective growth rate, which is 9.04%, compared to the 5.93% estimate in the anticipated notice.
“Every year for the announcement of rates, CMS updates the growth rates that are based on the most current estimation of per capita costs, based on the experience of the historical program of Avia and the allocation of trends projected at that time,” said the agency on the information sheet. “The change of growth rates between propose and end AS CMS incorporates data and updated assumptions. This year, the change in growth rates from the early warning to the announcement of rates is mainly due to the incorporation of additional [Medicare Fee-for-Service] Payment data, even to the fourth quarter of 2024 “.
The best Medicare alliance, a Medicare Advantage defense organization, came out in support of the payment rate, saying that it will provide some relief after a series of cuts.
“After two years of Medicare Advantage cuts, this payment rate will provide stability for millions of beneficiaries who have faced closures of plans, higher costs and reduced benefits,” said Mary Beth Donahue, president and executive director of Better Medicare. “Today, more than half of Medicare’s beneficiaries choose Medicare’s advantage for better care and better health results. The protection of this program has never been more important. We hope to continue working with the Trump administration, the CMS Oz administrator. Taxpayers.”
The alliance of community health plans (ACHP), which repeats local and non -profit health plans, also applauded the fees notice, as well as the decision of CMS to finish three years of the three -year access of the update of Ma Risky Paye is a path before before before for before for before for before for before for before for before for before for Forest. And their members are ill.
“The alliance of community health plans praises the Trump administration to finish the policies in the advantage of Medicare 2026 and the notification of rates of part D that reflect the highest care costs and to take another step towards the range in an aggressive risk adjustment to boost competition,” said Ceci Connolly, president and CEO of ACHP, in a statement. “ACHP has long supported the new MA risk adjustment model and is happy that CMS finally completes the transition. Elderly people deserve affordable attention based on evidence with doctors focused on providing that attention, rather Thanos.”
However, not everyone was delighted with this payment increase for Medicare Advantage plans. This includes the American Medical Association, which fought to stop a 2.8% cut in Medicare payments for doctors this year. Congress could not avoid this cut.
“The increase in salary to insurance companies, when they enjoy record profits, while the payment of doctors fighting our practices AFPROAT suggests a case of evil priorities. Doctors are the foundation of care care, the care of patients will suffer if doctors close their practices,” said the president of Ama, Bruce A. Scott, MD, in an advertise Announcement on Thursday.
The organization, together with the Medicare Payment Advisory Commission, is also asking the Congress to link Medicare payment updates for medical practices to the growth of the cost of providing care.
The payment rate occurred after the Senate confirmed Dr. Mehmet OZ last week as CMS administrator. Oz has been a great defender of the Medicare Advantage program in the past, extracting the scrutiny of someocrats who questioned if MA plans effectively regulate, which has faced criticism for excessive and inappropriate payments.
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