Care Continuum Alliance Remains Concerned about Market Destabilization due to CMS Proposed Changes to 2014 Medicare Advantage Methodology and Payments

CCA applauded lifting of annual limit on incentives and consideration for Medication Therapy Management

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Care Continuum Alliance, Voice of Population Health
We also applaud CMS for its efforts to support innovative programs that encourage beneficiaries to adopt and maintain healthy lifestyles by lifting the annual limit on incentives.

Washington, D.C. (PRWEB) March 08, 2013

The Care Continuum Alliance, the voice of the population health, submitted comments in response to a Call Letter issued by the Centers for Medicare and Medicaid Services (CMS) detailing the proposed changes to 2014 Medicare Advantage Methodologies and Payment Policies.

On February 15, 2013, the Centers for Medicare & Medicaid Services (CMS) released the Advanced Notice of Methodological Changes for Calendar Year (CY) 2014 for Medicare Advantage (MA) Capitation Rates, Part C and Part D Payment Policies and draft CY 2014 Call Letter.

“We are pleased CMS expressly encourages plans to offer Medication Therapy Management to beneficiaries in the proposed call letter,” states CCA. “We also applaud CMS for its efforts to support innovative programs that encourage beneficiaries to adopt and maintain healthy lifestyles by lifting the annual limit on incentives.”

CCA’s support for the elimination of the annual limits on incentives is based on the large and growing body of evidence that demonstrates the power of incentives to increase patient engagement and drive healthy behaviors. Incentives are an integral part of CCA members’ successful efforts to apply proven techniques of behavior change science in patient populations.

On the other hand, CCA expressed concerns that the significant proposed Medicare Advantage (MA) funding reductions could lead to Medicare Advantage market destabilization and unintended consequences to beneficiaries.

“When added to the reductions already required by the Affordable Care Act (ACA) for 2014, the cumulative reductions result in about an 8% cut in MA funding. If an eventual sequestration is included, this increases to a 10% reduction. These reductions have strong potential to cause disruptions the MA plan market and to MA beneficiaries through unexpected increased costs and decreased benefits to maintain fiscal sustainability,” according to CCA’s statement.

Recognizing that increasing value and savings in Federal health care spending are a must in the current environment, CCA made three key recommendations:

1.    Avert destabilization of the MA market and unanticipated encumbrances on beneficiaries by accounting for the annual Sustainable Growth Rate (SGR) adjustment to the Medicare Physician Fee Schedule.
2.    Phase in Fee-For-Service normalization reductions, past restatement of trend, and other rate calculation refinements.
3.     Omit the proposal to shift star scores closer to the mean and implement changes prospectively, in a manner that gives plans enough time to prepare for changes, to ensure measurement calculations more accurately reflect plan performance.

Read CCA Response to Call Letter – Methodological Changes for Calendar Year (CY) 2014 for Medicare Advantage Capitation Rates, Part C and Part D Payment Policies and 2014
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About the Care Continuum Alliance
The Care Continuum Alliance represents more than 200 organizations and individuals and aligns all stakeholders on the care continuum toward improving population health. Through advocacy, research and education, the Care Continuum Alliance advances strategies to improve care quality and outcomes and reduce preventable costs for the well and those with and at risk of chronic conditions. Learn more at http://www.carecontinuumalliance.org.