The Centers for Medicare & Medicaid Services on Wednesday announced proposed changes in Medicare Advantage (MA) capitation rates that include a 7.98% payment increase to MA plans in 2023. Higher payments could help MA plans expand supplemental benefits, which include home care. The change is part of CMS Advance Notice Fact Sheet.
CMS is also seeking comment on whether enhancements should be made to the CMS-Hierarchical Condition Categories risk adjustment model to address the impacts of social determinants of health on the health status of beneficiaries by incorporating additional factors that predict the relative costs of MA enrollees. The agency wants to assess how often plans are screening for common health-related social needs, such as food and housing insecurity, as well as transportation issues.
“Our goals for Medicare Advantage mirror our vision for CMS’ programs as a whole, which is to advance health equity; drive comprehensive, person-centered care; and promote affordability and the sustainability of the Medicare program,” CMS Administrator Chiquita Brooks-LaSure said in a statement. “[The] Advance Notice is one tool to engage our Medicare Advantage and Part D plan partners, and the communities we serve, as we work toward these goals.”
MA plans have been adding nonmedical services to their plans since CMS allowed them to begin offering supplemental benefits to the chronically ill in 2020. ATI Advisory recently said a quarter of MA plans now offer supplemental benefits. This year 1,300 MA plans are offering those benefits, a 40% increase over the 920 plans that offered them in 2021.
The comment period for Advance Notice runs through March 4, 2022. CMS will release its 2023 rate adjustments no later than April 4, 2022.
