search

Early Indications Of Changes To The 2015 Medicare Advantage Payment Methodology

posted by Oliver Wyman

on February 6, 2014

Introduction

The Centers for Medicare & Medicaid Services (CMS) will release the Advance Notice of Methodological Changes for Calendar Year 2015 Medicare Advantage Capitation Rates and Part C and Part D Payment Policies (the 2015 Advance Notice) on February 21, 2014. This notice is expected to outline the planned changes to Medicare Advantage (MA) capitation rates applied under Part C for CY 2015 and other regulatory changes that will affect plan reimbursement. Based on information released by CMS in its December 3, 2013 Actuarial Care Act (ACA), Medicare Advantage Organizations (MAOs) could experience substantial payment reductions for 2015. Such reductions would have a significant impact on the sustainability of MAO program participation and the ability of MAOs to provide stable benefits and beneficiary premiums to their members.