Skip to Main Content

The federal government is boosting the average payment to Medicare Advantage plans by 5% for 2023, higher than the 4.5% raise that was proposed in February.

The increase is one of the largest ever for Medicare Advantage, and due largely to the expectation that more Medicare enrollees will get care that had been put off throughout the pandemic. The boost could spur even more health insurers to join Medicare Advantage or beef up their presence within the lucrative but controversial taxpayer-financed program, which is on pace to cost $450 billion next year — more than the Departments of Education and Agriculture combined.

advertisement

Regulators also did not change any major policies related to “risk adjustment,” a system where Medicare Advantage insurers document and code the health conditions of their members as a way to garner higher payments. Earlier this year, many patient groups and watchdogs continued to urge Medicare officials to overhaul those coding practices and policies that have led to excessive payments, but their calls were ignored again in the final rule released Monday.

Unlock this article by subscribing to STAT+ and enjoy your first 30 days free!

GET STARTED