[{"innerBlocks":[],"name":"core\/freeform","postId":3336,"blockType":{"name":"core\/freeform","keywords":[],"attributes":{"content":{"type":"string","source":"raw"},"lock":{"type":"object"}},"providesContext":[],"usesContext":[],"selectors":[],"supports":{"className":false,"customClassName":false,"reusable":false},"styles":[],"variations":[],"apiVersion":3,"title":"Classic","description":"Use the classic WordPress editor.","category":"text"},"originalContent":"The Centers for Medicare and Medicaid Services must strengthen its oversight of Medicare Advantage contracts by examining data on disenrollment by health status and the reasons beneficiaries dis-enroll in the first place. Currently, CMS does not use available data to gain such insight.

That\u2019s the finding<\/a> of a new Government Accountability Office audit that examined 126 Medicare Advantage contracts with higher disenrollment rates\u2014above the median rate of 10.6 percent\u2014and found 35 contracts with health-biased disenrollment.

In these contracts, beneficiaries in poor health were substantially more likely (on average, 47 percent more likely) to dis-enroll relative to beneficiaries in better health, according to auditors, who concluded that such disparities in contract disenrollment by health status may indicate that the needs of beneficiaries\u2014particularly those in poor health\u2014may not be adequately met.

\u201cCMS does not use available data to examine data on disenrollment by health status as part of its ongoing oversight; thus, CMS may fail to identify problems in MA contract performance, which poses a risk as contracts are prohibited from limiting coverage based on health status,\u201d states the GAO report.

In addition, auditors found that the agency\u2019s oversight is inconsistent with internal control standards.

Also See: <\/b>GAO calls Medicare Advantage encounter data into question<\/a>

A CMS spokesperson declined to specifically comment on the GAO\u2019s findings and recommendations, and instead referred to the agency\u2019s official written response published in the audit report.

The Department of Health and Human Services\u2019 written response to the GAO concurs with the recommendation that HHS examine disenrollment data by health status and the reasons that beneficiaries dis-enroll.

\u201cHHS currently uses disenrollment data in its review of quality and performance of MA plans and through the MA Star Ratings,\u201d states the department. \u201cHowever, HHS will continue to consider ways to incorporate disenrollment data into its oversight of MA plans.\u201d

Last year, more than 30 percent of Medicare beneficiaries were enrolled in the MA program, through which CMS contracts with private entities to offer medical coverage. MA enrollment has increased from 11.1 million in 2010 to 17.6 million in 2016.
","saveContent":"The Centers for Medicare and Medicaid Services must strengthen its oversight of Medicare Advantage contracts by examining data on disenrollment by health status and the reasons beneficiaries dis-enroll in the first place. Currently, CMS does not use available data to gain such insight.

That\u2019s the finding<\/a> of a new Government Accountability Office audit that examined 126 Medicare Advantage contracts with higher disenrollment rates\u2014above the median rate of 10.6 percent\u2014and found 35 contracts with health-biased disenrollment.

In these contracts, beneficiaries in poor health were substantially more likely (on average, 47 percent more likely) to dis-enroll relative to beneficiaries in better health, according to auditors, who concluded that such disparities in contract disenrollment by health status may indicate that the needs of beneficiaries\u2014particularly those in poor health\u2014may not be adequately met.

\u201cCMS does not use available data to examine data on disenrollment by health status as part of its ongoing oversight; thus, CMS may fail to identify problems in MA contract performance, which poses a risk as contracts are prohibited from limiting coverage based on health status,\u201d states the GAO report.

In addition, auditors found that the agency\u2019s oversight is inconsistent with internal control standards.

Also See: <\/b>GAO calls Medicare Advantage encounter data into question<\/a>

A CMS spokesperson declined to specifically comment on the GAO\u2019s findings and recommendations, and instead referred to the agency\u2019s official written response published in the audit report.

The Department of Health and Human Services\u2019 written response to the GAO concurs with the recommendation that HHS examine disenrollment data by health status and the reasons that beneficiaries dis-enroll.

\u201cHHS currently uses disenrollment data in its review of quality and performance of MA plans and through the MA Star Ratings,\u201d states the department. \u201cHowever, HHS will continue to consider ways to incorporate disenrollment data into its oversight of MA plans.\u201d

Last year, more than 30 percent of Medicare beneficiaries were enrolled in the MA program, through which CMS contracts with private entities to offer medical coverage. MA enrollment has increased from 11.1 million in 2010 to 17.6 million in 2016.
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CMS needs to leverage Medicare Advantage disenrollment data

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