Payment

Plans must cover the same benefits as Traditional Fee-For-Service (FFS) Medicare, and these payments are risk adjusted to reflect the specific characteristics and anticipated cost of providing care to each beneficiary. Within this capitated payment, plans, providers, and community-based partners must work together to effectively care for the beneficiary. The goal of managing within a fixed payment is to encourage coordinated care that emphasizes prevention, customized care, and innovation to improve outcomes and prevent avoidable adverse events.

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Medicare Advantage Special Needs Plans: Issue Brief

Special Needs Plans (SNPs) are a specialized type of Medicare Advantage plan designed to serve the health care system’s fastest growing population – frail,...
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Fact Sheet
Key Facts: Over 3.5 million retirees nationwide, 20% of Medicare Advantage beneficiaries, are in EGWPs. Retiree enrollment continues to grow, nearly doubling since 2010. •...
Issue Brief
Introduction On February 1, 2017, the Centers for Medicare & Medicaid Services (CMS) released the Medicare Advantage 2018 Advance Notice and Draft Call Letter, which...
Letter
Dear Representative Tom Price and Seema Verma: We are writing to introduce Better Medicare Alliance (BMA) and highlight the advocacy work we do to support...
Issue Brief
On April 4, 2016 the Centers for Medicare & Medicaid Services (CMS) released the 2017 Medicare Advantage Final Rate Notice and Call Letter that can...