Payers Expect 3 Percent Medicare Advantage Payment Cut

Christopher Cheney, for HealthLeaders Media , April 11, 2014

"Despite CMS's actions [since February], Medicare Advantage plans will still face rate decreases for 2015. Aetna continues to evaluate the impact to our Medicare Advantage and Part D products but is committed to taking steps to ensure that our plans continue to provide beneficiaries with the great value and service they have come to expect. "

In a filing Tuesday with the federal Security Exchange Commission, Humana reported that the adjustments CMS had made since February shaved less than 1 percent off the company's previous estimate of a 2015 MA payment rate cut: "Based on a preliminary review of the Final Rate Notice, Humana expects a Medicare Advantage funding decline from CMS for 2015 of approximately 3 percent versus the previously expected funding decline of 3.5 to 4.0 percent. "

Tuesday's Humana SEC filing also provides a pair of key milestones for insurers in the 2015 MA timeline:

  • Bid designs for carriers' MA policy offerings are due at CMS by June 2.
  • Humana plans to share 2015 operating margin, earnings and membership expectations during the fourth quarter of 2014 after CMS makes 2015 benefit designs for the entire sector available.

Christopher Cheney is the senior finance editor at HealthLeaders Media.
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