Monday, June 27, 2016

"I think the biggest threats to the plans at this point are: payment cuts from a potential deficit reduction package in 2017 -

— and the potential that reductions in plan payments in Medicare Advantage (MA) and Part D might be used for further expansions or to offset state liability for duals; administrative payment reductions due to the mechanics of MA and Part D — risk adjustment, quality payments, and other technical matters in the control of CMS; instability in exchanges, which might come from political change or neglect of the program and dissolution of the present risk pool/increased churn of enrollment; and consolidation of providers resulting in less regional competition and difficulty in getting reductions in rates from providers as a result."

— Dan Mendelson, president of the Washington, D.C.-based consulting firm Avalere Health, an Inovalon Company, told AIS's Health Plan Week.

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