Fierce Healthcare January 26, 2023
Robert King

Currently, Medicare Advantage benchmarks are set based on historical fee-for-service in a given service area. But with the program growing so rapidly, changes to how such calculations are made might be needed. ((Getty/Steve Dunning))

Biden administration officials emphasized the need to change how Medicare Advantage’s (MA’s) benchmarks are calculated as the program’s popularity explodes but cautioned that any shifts would be very gradual.

Officials with the Centers for Medicare & Medicaid Services and the Center for Medicare and Medicaid Innovation (CMMI) spoke about MA during a webcast Wednesday held by consulting firm Moss Adams.

One of the key topics discussed was how to calculate MA benchmarks that determine the payment rate for a plan.

Currently,...

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