WASHINGTON, February 21 – Gorman Health Group (GHG), the leading consulting firm and solutions provider in government health care programs, has made available a summary and analysis of both the 2014 CMS Draft Call Letter and the Advance Notice for 2014 Medicare Advantage rates. Both documents are available for download for members of GHG’s “the Point”, on the Gorman Health Group website.
“The Advance Notice is a shocking, stark portrait of austerity,” says John Gorman, Executive Chairman of Gorman Health Group. “There’s nothing but bad news in it. All in all, CMS could cut as deep as 9-10% if the proposed rates become final on April 1. If the proposed rates become effective, it will lead to meaningful, painful cuts. Plans will try to shift some of the pain to providers, and doctors, hospitals and pharmacists will see another year of payment cuts.”
“These trends are a surprise,” writes leading expert Bill MacBain, Senior Vice President of Gorman Health Group at author of the Advance Notice summary. “Most of us were expecting the trend to be closer to zero or a slight positive. The culprit is the adjustment for errors in the years 2007 through 2012, which reduced the final figure by 3.4 percentage points. Add in the implications of the continued phase-in of the new rates under the ACA, unfavorable changes in how risk scores will be calculated, and the CMS proposal to disregard diagnoses documented in health risk assessments, plus the coding intensity adjustments, and the financial implications for MA health plans are profound indeed.”
Gorman Health Group makes regulatory summaries like these available on the Point, along with all the tools and analyses its consulting team use in delivering services to over 75 managed care and provider system clients each year. This unique subscription service makes it simple for its members to stay up to date. To learn more about the Point visit: www.gormanhealthgroup.com/thepoint.