The CMS is expected to release its final rate notice for Medicare Advantage plans for 2018 on Monday.
In February, it suggested a modest 0.25% increase, down from 0.85% bump last year. When factoring in the risk coding tendencies, the average change in Medicare Advantage insurers' revenue is expected to climb 2.75%, compared to a 3.05% increase in 2017.
The agency also suggested putting the brakes on plans to increase the use of encounter data -- information about the care an enrollee received by a provider -- to determine risk scores for plans.
The CMS intended to base 50% of payments on encounter data in 2018, but the industry pushed back over concerns that encounter data wasn't accurate. The agency again proposed to use the ratio set up in 2017. In that proposal, 75% of Medicare Advantage risk scores are based on traditional fee-for-service data and 25% are based on encounter data.
In a March 3rd comment from the American Hospital Association, the group suggested that encounter data should stop being used altogether after Government Accountability Office research showed the information isn't accurate.
“We remain concerned that the use of encounter data may result in inaccurate risk scores,” Tom Nickels, AHA's executive vice president said in the letter.
