HealthLeaders Media February 6, 2024
This time, CMS is to blame for upsetting Humana’s funding expectations for 2025.
KEY TAKEAWAYS
– Coming on the heels of a huge fourth quarter loss, Humana may have to lower its benchmark funding by around 160 basis points.
– Although MA has historically been lucrative for insurers, recent regulatory changes and rising costs are putting the offering at risk.
– We may see an uptick in MA payers raising premiums, reducing benefits, and even considering leaving certain markets to improve margins—changes that would make providers even less likely to keep their MA contracts.
CMS recently released its proposed Medicare Advantage (MA) payment rules for 2025—and it includes a 0.2% decrease in average benchmark payment rates for next year.
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