Here are the highlights from the CMS Advanced Notice of Methodological Changes to 2007 MA Rates and Part D Payments: GENERAL: The National Per Capita Growth percentage is used to baseline the rate tables for 2007. The rate is estimated at 6.9%. It is still not possible to predict the final impact on reimbursement...
Read more »
Next to the roll out of PART D, the implementation of Medicare’s HCC Risk Adjustment reimbursement model for Medicare Advantage plans is one of the most significant changes to the Medicare industry. In 2007 plans will receive 100% of their reimbursement based on the HCC Risk model that pays higher rates for beneficiaries who...
Read more »
Background on Payments for Medicare Advantage Plans Medicare advantage plans are private managed care plans that offer typically offer benefits beyond traditional fee for service Medicare. Plan bids outline the benefit packages offered to an area and the beneficiary contributions, if any. By law, CMS is required to publish the Medicare Advantage payment rates...
Read more »
Medicare Advantage (MA) Plans are beginning to plan for all of the anticipated changes in payments and reimbursements and there are many planned in 2007. Here are just a few factors that will determine who wins and loses on the battle for MA plan reimbursements: 100% Risk Adjustment – 2007 will be the first...
Read more »
Earlier we talked about industry collaboration and how it is essential in successfully manage your Medicare business. In California the group, Industry Collaboration Effort (ICE) has done an outstanding job of volunteer professionals working to develop information, processes and tools to better manage Medicare. Take a look at some of the amazing tools and...
Read more »
