Why higher Medicare Advantage utilization wasn’t reflected in 2025 rates

(By Jakob Emerson for Becker’s Hospital Review)

CMS has finalized a slight decrease in Medicare Advantage benchmark payments for 2025, despite large insurers reporting rising costs and utilization among MA members.

“We are aware of numerous reports from MA organizations and stakeholders stating that MA organizations’ trends, especially for fourth quarter 2023, are inconsistent with [Medicare FFS cost trends],” CMS wrote April 1. “We are not aware of all of the specific drivers accounting for the experience of these MA organizations. We have reviewed incomplete fourth quarter 2023 Medicare FFS incurred experience and it is consistent with our projections.” Continue reading here…

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