Plans Oppose Flat 2027 MA Rates
In comments on the proposed 2027 Advance Notice of rates, Medicare Advantage (MA) plans say a flat rate will mean reduced benefits and services and increased out-of-pocket costs for seniors. UnitedHealth Group estimates the proposed rate increase would lead insurers to reduce benefits by more than $600 a year. AHIP says its actuary Wakely determined no-premium plans could face a 50% cut to supplemental benefits and increased out-of-pocket costs by $1,000. Premiums could increase $23 per month, resulting in a jump of more than $550 for a couple each year.
The plans also argue rising utilization and costs are being ignored.
In addition, Humana, insurer trade group AHIP, and the Blue Cross Blue Shield Association want the proposed changes to risk adjustment regarding chart reviews not linked to encounters to be delayed until 2028. UnitedHealth Group and the Better Medicare Alliance recommend that CMS implement this change gradually rather than all at once next year. AHIP and the Alliance of Community Health Plans say plans should be able to use chart reviews to score new members.
I expect final rates to increase by between 2% and 3%.
Additional article: https://www.beckerspayer.com/research-analysis/benefits-coverage-for-no-premium-plans-could-drop-50-under-2027-ma-rule-ahip/
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#medicareadvantage #rates #riskadjustment
Cordani To Retire
Longtime Cigna CEO David Cordani will retire this summer. Cordani will leave the CEO spot and become executive chair. Cigna’s Chief Operating Officer Brian Evanko will become CEO. Evanko spent multiple decades with the company including as CFO.
Cordani truly transformed the company over 17 years leading the company, including by building its services entity Evernorth. He also seemed prescient by exiting Medicare Advantage (MA) recently as the line of business tanked overall.
Additional articles: https://www.fiercehealthcare.com/payers/longtime-cigna-ceo-david-cordani-retire-brian-evanko-tapped-successor and https://www.healthcaredive.com/news/brian-evanko-succeed-david-cordani-cigna-ceo/813619/
(Some articles may require a subscription.)
#cigna
https://www.modernhealthcare.com/insurance/mh-cigna-brian-evanko-david-cordani-ceo
Oz Cites Doctor Distrust For Slow PA Transformation
Centers for Medicare and Medicaid Services (CMS) Administrator Dr. Mehmet Oz says that doctors’ distrust of insurers is one reason real-time prior authorization (PA) hasn’t happened yet. He says plans say doctors do not wish to share the necessary data and would rather do so on paper.
At an appearance Oz also discussed the $50 billion rural health initiative and fraud, waste, and abuse.
#priorauthorization #physicians #healthplans
https://www.medpagetoday.com/publichealthpolicy/medicare/120146
KFF Looks At Part D Program in 2027
Healthcare policy group KFF analyzed the latest enrollment for the Part D program overall. It shows that 56.1 million people are enrolled in Medicare Part D as of February 2026, including both non-group and group plan enrollment. About 56% of Part D enrollees are in Medicare Advantage-Part D plans with 44% in standalone Part D PDPs.
Between February 2025 and February 2026, enrollment growth in non-group MA-PDs (including both individual plans and Special Needs Plans (SNPs) exceeded growth in non-group PDP enrollment. There was a modest reduction in overall MA-PD enrollment between February 2025 and February 2026 due to a shift in enrollment among employer group plan enrollees from group MA-PD plans to group MA-only plans with separate PDPs. Standalone PDPs went from 23.2 million in 2025 to 24.9 million in 2026. Although overall MA grew by 874K from 2025 to 2026, MA-PDs declined from 31.4 million to 31.3 million, while standalone PDPs grew from 23.2 million to 24.9 million.
#partd #pdp #medicareadvantage
https://www.kff.org/medicare/analyzing-changes-in-medicare-part-d-enrollment-for-2026/
— Marc S. Ryan
