MA Star Bonus To Exceed $13B
Healthcare policy group KFF reports that federal spending on Medicare Advantage (MA) quality bonuses will reach at least $13.4 billion in 2026, compared with $12.7 billion in 2025. This is more than four times higher than in 2015. More than two-thirds of Medicare Advantage enrollees (68%) are in plans that qualify for the quality bonus in 2026, down from 75% in 2025. This is the lowest since 2018. The increase ties to more enrollment not better ratings.
In another briefer, KFF updates on MA coding intensity.
Additional article: https://www.kff.org/medicare/decoding-medicare-advantage-coding-intensity/
#medicareadvantage #radv #riskadjustment #stars #quality #cms
Home Health Hike For 2027
The Centers for Medicare and Medicaid Services (CMS) issued a proposed rule that would increase Medicare payments to home health providers by 2.4% in 2027. In addition, the rule would make it easier to bar providers and suppliers from Medicare over fraud.
In other news, in addition to suing the state for fraud, the Trump administration revealed that it will suspend funding for New York’s Medicaid Fraud Control Unit.
Additional articles: https://www.fiercehealthcare.com/regulatory/trump-administration-withholds-funds-new-yorks-medicaid-fraud-unit and https://www.modernhealthcare.com/politics-regulation/mh-cms-home-health-pay-2027/ and https://www.beckershospitalreview.com/finance/cms-seeks-new-powers-to-remove-problematic-medicare-providers-8-things-to-know/
(Some articles may require a subscription.)
#fwa #medicare #cms
Major Financial Disclosure For Hospitals
A new House Ways and Means Committee bill would mandate greater disclosures of tax-exempt hospital operations and finances, including tax-exempt health systems to provide details such as how they are addressing the community health needs identified in their annual assessments, the value of the financial assistance they provide patients, and how many financial assistance applications are received and approved.
(Article may require a subscription.)
#hospitals #transparency
https://www.modernhealthcare.com/politics-regulation/mh-house-tax-exempt-hospital-transparency-act
— Marc S. Ryan
