With MA Cuts Coming, Home Care Supplemental Benefits Hang In The Balance

Home Health Care News | By Andrew Donlan
 
Home care providers have complained about Medicare Advantage (MA) becoming a more mainstream payer source.
 
Still, many have begun to work with MA plans for the first time over the past few years. But now, there’s concern that the government’s crackdown on MA could restrict opportunities even further, particularly when it comes to supplemental benefits.
 
“There’s no question that the recently proposed risk-adjustment policy would reduce payments enough that plans would certainly reduce supplemental benefit offerings,” ATI Advisory founder and CEO Anne Tumlinson told HHCN in an email.
 
Specifically, the U.S. Centers for Medicare & Medicaid Services (CMS) is attempting to cut plans’ payment rate by 2.27%. CMS is also hoping to regain billions of dollars in overpayments from major insurers in the near-term future.
 
That, some believe, could mean that plans are “less generous” with the supplemental benefits they offer. Health Affairs covered the issue in an analysis published Wednesday.
 
“Concerns that … plans are overpaid have motivated calls to reduce MA benchmarks – the dollar amounts set by [CMS] against which MA plans bid to set premiums and fund extra benefits,” the Health Affairs analysis states. “However, cutting benchmarks may lead to higher MA enrollee premiums and decreased plan generosity.”

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