The final 2027 Medicare Advantage Rate Announcement provided some relief to a still displeased industry.
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 Rate Announcement. It provided some relief to a still displeased industry.
Key Takeaways:
Medicare Advantage (MA) plans got a bit of relief from CMS initial proposal of a 0.09% rate hike in 2027.
The final adjustment will be 2.48%.
CMS gave in a bit to the industry and pulled back on another proposed risk adjustment model change.
It will follow through on some risk adjustment reform by barring unlinked charts (those not connected to an actual provider encounter) in most cases.
The rate hike is far below what has been seen in terms of utilization.
The hike will mean about $13 billion in new dollars to MA plans, up from under $1 billion proposed.
But because most plans do not have aggressive risk adjustment practices, most plans will see an increase closer to 4%.
Big plans will bear the burden of most of the unlinked chart reform.
The 2027 modest hike is yet another sign that CMS will be stingier on rate dollars in the future.
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Resources:
The Healthcare Labyrinth: A Guide to Navigating Health Plans and Fixing American Health Insurance
