On April 2, 2018, the Centers for Medicare & Medicaid Services (CMS) released its 2019 Rate Announcement and Call Letter revising Medicare Advantage (MA) program regulations and the Prescription Drug Benefit program (Part D) for 2019. The announcement contained important changes to the MA risk adjustment program as well as the MA Star Ratings program.
Here, Verscend summarizes the key takeaways for MA plans and offers insights from our customer base, including:
- How the CMS-HCC risk adjustment model is changing
- Why CMS deferred action on condition count modeling
- What challenges the new 75 percent/25 percent RAPS/EDS mix may bring
- Which Star Ratings measures CMS is adding or changing