Press ReleasesBLOG POST: CMS Proposed 2023 Rate Notice for MA and Part D Plans and the Drive for Greater Health Equity

CMS recently released proposed changes to payment policies to Medicare Advantage and Part D drug programs for next year that are aimed at increasing health equity and giving consumers more plan options and affordable choices.^1,2

As part of its effort, CMS plans to:

• Collect more robust and complete data on the ethnicity, race and social determinants of health of beneficiaries
• Develop methodologies and quality measures to better address and bolster the ways it addresses health disparities
• Instill value in Medicare to make sure funds are spent efficiently and effectively to reduce gaps in health equity.³

“Our goals for [MA] mirror our vision for CMS’ programs as a whole, which is to advance health equity; drive comprehensive, person-centered care; and promote affordability and the sustainability of the Medicare program,” CMS Administrator Chiquita Brooks-LaSure said.⁴

CMS is also creating a Health Equity Index, which would summarize social risk factor performance measures for MA and Part D plan providers into one score to increase transparency.^2,3 The agency would reward programs based on their index scores, which would take into account how many of their beneficiaries face social risk factors.^3,4

The agency predicted a 7.98% revenue increase for MA and an effective growth rate of 4.75% for 2023.^3,5

America’s Health Insurance Plans signaled support for CMS’ increased focus on health equity. “MA plans play an essential role in improving health equity and addressing the social determinants of health that impact millions of seniors and people with disabilities,” said AHIP President and CEO Matt Eyles.⁵

CMS is accepting comments on the proposals until March 4, and the final rate is set to be published April 4.^3,5

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^References

1. CMS Releases 2023 Medicare Advantage and Part D Advance Notice. CMS. Feb. 2, 2022. https://www.cms.gov/newsroom/press-releases/cms-releases-2023-medicare-advantage-and-part-d-advance-notice
2. Ninemyer, Paige. CMS puts focus on health equity in Medicare Advantage, Part D Advance Notice. Fierce Healthcare. Feb 3, 2022. https://www.fiercehealthcare.com/regulatory/cms-puts-focus-health-equity-medicare-advantage-part-d-advance-notice
3. Advance Notice of Methodological Changes for Calendar Year (CY) 2023 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies. CMS. Feb. 2, 2022. https://www.cms.gov/files/document/2023-advance-notice.pdf