Learn What Else CMS Has in Store for MA & Part D Plans

Why This Topic Matters

These CMS proposals can affect plan reimbursement, risk adjustment methodology, and quality measurement strategies for Medicare Advantage and Part D organizations.

Article Sections

1. Net Payment Increase

   Summarizes CMS’s projected payment impact across Medicare Advantage and Part D plans.

2. Revised Risk Adjustment Model

   Describes proposed updates to the CMS-HCC framework for Part C payments and the affected beneficiary groupings.

3. Updated RxHCC Model for Part D

   Covers the proposed Part D risk adjustment model update used for plan payment adjustment.

4. Bid Requirements Waiver

   Discusses the proposed change to Employer Group Waiver Plan bidding and related payment methodology.

5. Blended Risk Scores

   Explains the proposed approach to combining data sources for plan-submitted diagnosis information.

6. Adjusted Star Rating Measures

   Reviews proposed interim analytical adjustments and possible future additions to Star Rating measures.