According to HME News, CMS (The Centers for Medicare & Medicaid Services) has outlined policy changes for Medicare Advantage in 2027. Policy details are outlined in this notice, but we’ve listed a few important highlights below:
- Small payment growth: CMS projects a small overall Medicare Advantage payment growth for 2027 (a year-over-year net payment increase of 0.09% - just over $700 million - in Medicare Advantage plan payments). This is far below what insurers had expected, having received about over a 5% payment bump for 2026.
- Tighter risk adjustment rules: CMS proposes updating MA and Part D risk adjustment models and excluding diagnoses from audio-only telehealth and unlinked chart reviews
- Part D model updates: Prescription drug payment models would be updated to reflect recent cost data and Inflation Reduction Act benefit changes, with refinements for different plan
This is an advance notice. CMS is seeking public comment before finalizing rates and policies in the 2027 Rate Announcement.
CMS Administrator DR. Mehmet Oz stated: “These proposed payment policies are about making sure Medicare Advantage works better for the people it serves.”
However, health care stocks are speaking a different word, plummeting on Tuesday after the Trump administration proposed this plan.
Dig deeper into the CY 2027 Advance Notice fact sheet here.
