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2023 Medicare Advantage Part D Rate Gets 8.5% Revenue Hike

CMS touts goals to advance health equity; drive comprehensive, person-centered care; and promote affordability of the Medicare program

April 14, 2022  – The Centers for Medicare & Medicaid Services (CMS) recently released the Calendar Year 2023 Medicare Advantage Capitation Rates and Part C and Part D Payment Policies. In the release, CMS announced an 8.5% increase on average to payer revenues in the CY 2023 Medicare Advantage and Part D rate. 

The final rate increase was higher than the 7.98% that CMS stated in their Advanced Notice. The announced Effective Growth Rate of 4.88% is also slightly higher than the 4.75% released in the Advanced Notice. 

Reactions to the Medicare Advantage Rate Announcement

Early reactions to the final rate notice thus far seem to be positive. 

Mary Beth Donahue, president and chief executive officer of the Better Medicare Alliance stated, “While we continue to review details, this is a Rate Announcement that puts beneficiaries first and ensures stability and continuity of care for the more than 28.5 million seniors and individuals with disabilities who choose Medicare Advantage nationwide.”

Many payer organizations are applauding CMS for their focus on health equity in the Medicare Advantage Rate Announcement. Through the announcement, CMS touts its drive to address social determinants of health and health disparities. 

While many reactions are positive, there are some concerns with the pharmacy price concessions in Medicare Part D and the new calculations for out-of-pocket costs for DSNPs.

 “We appreciate that with this final rate notice, the Administration continues to support innovation and flexibility in MA to improve affordability, access, and value for enrollees and taxpayers,” said AHIP in a released statement. “However, we are concerned that due to separate and ongoing rulemaking, several policies remain in question, which if finalized would be unworkable and could negatively impact seniors by increasing premiums or reducing benefits.”

With the Rate Announcement, Medicare Advantage Plans are now being finalized in advance of the June 6th deadline. 

To read more about the Rate Announcement, click here to view the CMS fact sheet. 

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