As we look towards the future, it’s important to start thinking about what changes are coming to Medicare Advantage in 2024. Although 2024 may seem far off, it’s never too early to start thinking about what’s ahead and what to expect from Medicare Advantage. In this article, we’ll explore the various changes that are expected to come to Medicare Advantage plans 2024 and what you should be watching out for.
- Risk Adjustment Changes
One of the most significant changes that Medicare Advantage plans will face in 2024 is a new system for calculating risk adjustments. This new system will be based on Hierarchical Condition Categories (HCCs), which are a way of coding the risk of various medical conditions. This new system will aim to more accurately determine the risk of each Medicare Advantage member and adjust payments accordingly.
However, there are some concerns that this new system could lead to cuts in payments to Medicare Advantage plans. This is because the new system will be more precise in determining the risk of each member, which could lead to fewer people being considered high-risk and therefore fewer payments to plans for taking on those high-risk members.
- Infusion Therapy Payment Changes
Another change that Medicare Advantage plans will need to watch out for in 2024 is a significant change in payment for infusion therapy. Currently, Medicare Advantage plans receive a separate payment for infusion therapy services, which can be expensive. However, in 2024, Medicare Advantage plans will be required to bundle these payments into their overall plan payment.
This change could lead to some Medicare Advantage plans deciding to drop coverage for infusion therapy services altogether, as they may not be able to afford the cost. However, for providers, this change could lead to an increase in the number of patients they see for infusion therapy, as more patients may choose to receive this type of treatment.
- Changes to Star Ratings
Star ratings are a key factor in determining Medicare Advantage plan payments and reimbursement rates. In 2024, there will be changes to the way that these star ratings are calculated, with some new measures being introduced.
One of the most significant changes is the introduction of a new care continuity measure. This measure will track whether Medicare Advantage members have the same primary care provider from year to year, which is seen as an important factor in ensuring that members receive high-quality care.
In addition, there will be changes to the way that medication adherence is measured, with plans being held to stricter standards. This could lead to some Medicare Advantage plans struggling to maintain their star rating, as they may struggle to meet these new measures.
- Digital Health Changes
One of the most exciting changes that Medicare Advantage plans can look forward to in 2024 is the introduction of new digital health tools. These tools will aim to make it easier for Medicare Advantage members to manage their health and keep track of their care.
Some of these tools include telehealth services, remote monitoring devices, and mobile apps that allow members to track their progress towards their health goals. These tools can help to improve care coordination and reduce the need for in-person visits, saving both time and money.
- Potential Political Changes
Finally, it’s important to note that there could be significant political changes that could impact Medicare Advantage plans in 2024. This is because 2024 is a presidential election year, and the outcome of the election could impact the direction that Medicare policy takes.
For example, a new administration could choose to reverse some of the changes made by the current administration in recent years, such as the expansion of telehealth services. Alternatively, a new administration could choose to introduce new policies that could impact Medicare Advantage plans in unforeseen ways.
Conclusion:
In conclusion, there are many changes coming to Medicare Advantage in 2024 that plans will need to watch out for. From changes to risk adjustment and infusion therapy payments to changes to star ratings and the introduction of new digital health tools, there are many potential challenges and opportunities ahead. By staying informed and being proactive, Medicare Advantage plans can prepare themselves for the changes that are coming and continue to provide high-quality care to their members.