April 06, 2016 12:00 ET
BEDFORD, MA–(Marketwired – Apr 6, 2016) – LogixHealth, a leading provider of internet and software enabled coding, billing, analytics and management services for hospital and physician practices nationwide, provides services for millions of Emergency Department (ED) visits across 35 states, and has analyzed the 2017 payment and policy updates for Medicare Health and Drug Plans.
On April 4th The Centers for Medicare & Medicaid Services (CMS) released the final Medicare Advantage and Part D Prescription Drug Program changes for 2017. Medicare Part D provides coverage for prescription medications both as a stand-alone plan and also as part of Medicare Advantage plans that include prescription coverage. Enrollees pay monthly premiums ranging from a few dollars to over 100 dollars. In addition to announcing the 2017 rates, CMS released updated Medicare Advantage and Part D payment methodologies that are intended to improve payment precision, encourage quality, and to protect beneficiaries from significant cost increases. The new 2017 policies will improve the accuracy of payments to Medicare Advantage plans that serve dually eligible or low-income beneficiaries, making these important prescription benefits more available to a key cohort of patients.
Importantly, Medicare part D enrollment now exceeds 17 million and has increased by more than 50 percent since passage of the Affordable Care Act and covers 32% of Medicare Advantage plan enrollees. The percentage of Medicare Advantage enrollees in plans with ratings of four or five stars has almost quadrupled since 2009 to 71 percent. Additionally, roughly one third of prescription drug plan enrollees are in standalone Part D plans with four or more stars, compared to 27 percent of enrollees in such plans in 2009.
“CMS is refining the rating methodology, including a 2017 adjustment for low income subsidy or dual eligible patients,” states Michael Granovsky, MD, FACEP President of LogixHealth.
The rate announcement and call letter may be accessed at: https://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/Announcements-and-Documents.html and selecting “2017 Announcement.
LogixHealth, a leading provider of internet and software enabled coding, billing, analytics and management services for hospital and physician practices nationwide, provides services for millions of Emergency Department (ED) visits across over 35 states. We provide tools and resources to optimize financial performance and improve the quality of care. For more information, visit www.logixhealth.com.