From Medicare Advantage News - Trade associations representing Medicare Advantage plans serving disadvantaged populations expressed numerous reservations about the two options CMS last month requested comments on for offering interim relief on star quality ratings for such plans (MAN 12/3/15, p. 1). In their comment letters filed by the Dec. 10 CMS deadline, the associations all thanked CMS for seeking ways to help these financially ailing plan sponsors in the short run, but said they had numerous questions remaining even after a Dec. 3 one-hour CMS conference call on the two options. And they generally voiced doubts about how effective either option would be in… Read more
From Medicare Advantage News - In what may be a cautionary tale amid the push to shift risk to providers in Medicare Advantage contracting in areas not used to it, 10,000-member Touchstone Health HMO will close at the end of this year. The White Plains, N.Y.-based MA plan has struggled financially, as have several larger New York MA sponsors recently, resulting in losses of network providers and members coupled with low albeit improving star quality… Read more
From Medicare Advantage News - Trade groups representing Medicare Advantage plans with large percentages of Medicare-Medicaid dual-eligible members say they’re very encouraged by an Oct. 28 CMS memo stating it’s considering a major revision in risk adjustment for 2017 that would pay different rates for full and partial duals. But industry consultants caution that until CMS furnishes the “coefficients” it will use in the new model classifications, plans won’t know for sure whether they will… Read more
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