While the basic structure of the model and the HCCs will remain the same, CMS proposes the following two updates to the ESRD model for 2019:
1. Update the data years underlying the model, and;
2. Update the Medicaid factors to be concurrent with the payment year.
Overall, CMS is projecting a 1.84% overall increase to Medicare Advantage revenue, based on an effective growth rate of 4.35% offset primarily by a decrease in normalization of -2.26%. As with everything else, it all depends on your member make-up and geography.
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