CMS to Medicare plan bidders: Spend less

By Allison Bell

February 20, 2013

The federal Centers for Medicare & Medicaid Services (CMS) wants the national per capita "growth percentage" for the Medicare Advantage plans that cover the aged and disabled to be minus 2.3 percent.

The growth percentage is turning into a shrink percentage because CMS is expecting per-capita plan medical costs to fall 3.2 percent, CMS officials said in a 199-page description of the 2014 Medicare plan bidding methods. 

CMS officials are expecting the per-capita cost for the traditional fee-for-service Medicare program for the aged and disabled to fall 2.1 percent.

"We appreciate that plans are facing several legislatively mandated changes affecting payment for 2014, and this may present challenges for plans," CMS officials said in the bidding document.

Comments on the document are due March 1.

CMS is looking for ideas about ways that plans can cope with the changes and still comply with federal law, and it also is looking for ideas about ways to change the requirements to make administration of private Medicare plans more efficient while improving delivery of care, officials said.

The Patient Protection and Affordable Care Act of 2010 (PPACA) created a new method for calculating Medicare Advantage county rates and also requires CMS to rebase the county fee-for-service rates, which are the basis for establishing Medicare Advantage rates, at least once every three years.

CMS intends to rebase the county fee-for-service rates in 2014, officials said.

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