December 7, 2022

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CMS releases 2023 Medicare Advantage and Part D Advance Notice

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Picture: Cecilie Arcurs/Getty Images

On Wednesday, the Centers for Medicare and Medicaid Services introduced proposed payment plan adjustments for Medicare Gain and Aspect D drug programs in 2023 that are meant to generate much more decisions and supply economical solutions for shoppers. 

The Calendar Year 2023 Progress Observe for Medicare Advantage and Component D programs is open to public comment for 30 times. This 12 months, CMS is soliciting input by way of a well being fairness lens on the approach to some future opportunity alterations.

The agency’s conclude purpose for Medicare Advantage is to match CMS’ eyesight for its programs as a complete, which Administrator Chiquita Brooks-LaSure mentioned is “to progress wellbeing equity generate in depth, particular person-centered treatment and endorse affordability and the sustainability of the Medicare program.”

CMS is proposing an efficient development level of 4.75% and an all round envisioned ordinary transform in earnings of 7.98%, next a 4.08% revenue maximize prepared for 2022.

What’s THE Effect?

CMS is requesting enter on a potential improve to the MA and Portion D Star Ratings that would choose into account how very well each and every system improvements wellbeing fairness. 

The agency is also requesting remark on which include a excellent measure in MA and Part D Star Rankings that would evaluate how normally programs are screening for common wellness-linked social requirements, these kinds of as meals insecurity, housing insecurity and transportation troubles.

The Well being Fairness Index has been tasked with making more transparency on how MA programs treatment for disadvantaged beneficiaries. 

Furthermore, CMS is requesting input on criteria for examining the effects of working with sub-condition geographic stages of fee placing for enrollees with end-stage renal condition, particularly enter regarding the impression of MA payment on care offered to rural and urban underserved populations and how these types of payment changes may possibly impression health and fitness fairness.

Other parts in which CMS is soliciting input include things like a range of payment updates a new evaluate concept to evaluate regardless of whether and how MA ideas are reworking treatment by partaking in value-based mostly versions with companies and updates to threat adjustment versions to carry on to fork out correctly for men and women enrolled in MA and Section D strategies.

General public feedback on the Advance Discover need to be submitted by March 4. The Medicare Advantage and Element D payment policies for 2023 will be finalized in the 2023 Charge Announcement, which will be printed no later on than April 4.


The proposed rule has by now elicited reaction from various organizations, including Improved Medicare Alliance.

“As we go on to critique the Progress Observe in even more detail, we recognize that CMS has supplied a thoughtful proposal that will help ensure balance for the thousands and thousands of varied seniors and folks with disabilities who depend on Medicare Edge,” Mary Beth Donahue, president and CEO of the Much better Medicare Alliance, reported, adding that the proposal furthers the shared intention of increasing overall health equity.

“Medicare Advantage has demonstrated its worth for seniors and taxpayers furnishing decrease costs, meaningful gains that handle social determinants of wellbeing, improved outcomes and better efficiencies for the Medicare dollar,” she said. “A stable amount for 2023 assures this perform can proceed. On behalf of our 170 Ally corporations and above 600,000 beneficiary advocates, we applaud CMS for putting seniors initially by issuing an Advance Observe that safeguards coverage choices, advancements wellness equity and preserves affordability for beneficiaries.”

AHIP also responded, with President and CEO Matt Eyles pointing out that for 2022 the regular Medicare Advantage regular high quality dropped to $19, representing a lessen of extra than 10% considering that 2021.

“We concur that MA programs engage in an important job in improving upon overall health fairness and addressing the social determinants of wellbeing that impact millions of seniors and individuals with disabilities,” he stated. “We help CMS soliciting input on strategies to advance these essential targets.

“Medicare Benefit enjoys powerful bipartisan aid due to the fact it offers America’s seniors and people with disabilities with entry to cost-effective, higher-top quality healthcare expert services,” claimed Eyles. “We will proceed to critique the 2023 fee notice and glimpse forward to furnishing constructive responses to CMS through the remark time period.”

THE Larger Trend

CMS’ Progress Observe follows a the latest congressional letter in which 346 bipartisan associates of Congress declared support for Medicare Gain and urged the agency “to deliver a steady fee and coverage ecosystem” for the system in 2023.

A December 2021 Early morning Check with poll showed that 94% of Medicare Benefit beneficiaries are content with their coverage, even though 93% consider that safeguarding MA need to be a precedence of the Biden administration.

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