CMS proposes $21B payment increase for Medicare Advantage in 2026: 10 notes

Becker's Healthcare January 10, 2025
Rylee Wilson

CMS is proposing a more generous increase in payments to Medicare Advantage plans in 2026 than in previous years.

The agency published its advance notice for payments to Medicare Advantage plans Jan. 10. CMS estimates payment rates will increase by 4.33%, or $21 billion, to MA plans in 2026.

Here are 10 things to know about the proposed rule:

1. The projected increase is higher than in years past. In 2024, CMS estimated payments to MA plans would increase by 3.32% in 2024, and by 3.7% in 2025.
2. The agency will complete the three-year phase-in of risk adjustment changes in 2026. The changes shift MA’s diagnosing coding from ICD-9 to ICD-10 and remove certain codes from the...

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