The final 2027 Medicare Advantage and Part D rule cemented some major changes in Star Ratings that will have far-reaching revenue impacts.
About The Podcast:
Millions of Americans feel confused and frustrated in their search for quality healthcare coverage.
Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change.
Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Podcast offers accessible, incisive deep dives on the most pressing issues and events in American healthcare.
Marc seeks to help Americans become wiser consumers and navigate the healthcare maze with more confidence and certainty through The Healthcare Labyrinth website and his book of the same name.
Marc is an unconventional Republican who believes that affordable universal access is a wise and prudent investment. He recommends common-sense solutions to reform American healthcare.
Tune in every week as Marc examines the latest developments in space, offering analysis, insights, and predictions on the changing state of healthcare in America.
About The Episode:
On this episode, Marc discusses the final 2027 Medicare Advantage and Part D rule. It cemented some major changes in Star Ratings that will have far-reaching revenue impacts.
Key Takeaways:
The 2027 Medicare Advantage and Part D rule was finalized with major Star Ratings changes.
The EHO4all health equity reward was retroactively rescinded, and the Reward Factor will be kept.
Thirteen of 14 measure retirements were finalized, most of which are easy-to-hit operational measures.
A new Depression Screening measure was adopted as well.
The effect of the measure changes means clinical measures now are weighted almost half of overall star ratings, with CAHPS and HOS measures over a third.
At least 25% of contracts are expected to lose a half Star rating, with others seeing their performance drop to put higher ratings out of reach.
Other reforms adopted include repealing many health equity mandates, reining in and reforming supplemental benefits, and codifying many Part D changes.
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Resources:
The Healthcare Labyrinth: A Guide to Navigating Health Plans and Fixing American Health Insurance
