posted by AHIP
on March 1, 2019
On December 20, 2018 and January 30, 2019, the Centers for Medicare & Medicaid Services (CMS) released the payment year (PY) 2020 Advance Notice Parts 1 and 2 (Notice), respectively. Part 2 also included the Call Letter.
America’s Health Insurance Plans (AHIP) has retained Wakely Consulting Group, LLC (Wakely) to provide a financial impact summary report of the information presented in the Notice, as well as an analysis of the impact of two, proposed Encounter Data Submission (EDS) risk adjustment models described in Part 1 of the Notice.
The CY2020 fee-for-service (FFS) growth rate, which is now the major driver of Part C benchmark rates, is 4.52%. There are several other components of the benchmark determination that affect the expected benchmarks and payment for 2020 as compared with 2019.
These components can be broken down into two main parts:
More details on the analyses underlying these estimates are described in this report.