This fact sheet explains how the Centers for Medicare & Medicaid Services (CMS) determines annual payment updates to rates for Medicare Advantage and Medicare Prescription Drug Plans (Plan D) in its Advance Notice and Rate…
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.
This fact sheet explains how the Centers for Medicare & Medicaid Services (CMS) determines annual payment updates to rates for Medicare Advantage and Medicare Prescription Drug Plans (Plan D) in its Advance Notice and Rate…
CLAIM: A Kaiser Health News story published today claims that "federal audits reveal widespread overcharges and other errors in payments to Medicare Advantage." FACTS: The data used in Kaiser Health News' story is, in some cases, more…
By Mary Beth Donahue and Jerry Penso, M.D. As Medicare’s annual open enrollment period begins, Medicare beneficiaries will find high-quality and affordable coverage options to choose from, including increasingly popular Medicare Advantage plans. The Centers…