U.S. health regulator proposes insurer payments for Medicare
The U.S. government on Friday announced proposed payments to private health insurers for 2015 Medicare Advantage plans, amid pressure from the industry and Congress to avoid cuts that would hurt benefits for the elderly and disabled.
The proposal, released in a document by a division of the U.S. Department of Health and Human Services, lays out a benchmark amount of reimbursement that insurers use to help set prices on private Medicare plans.
Insurers including UnitedHealth Group Inc, Humana Inc and Aetna Inc manage private Medicare plans for about 15 million of the 50 million Americans eligible for Medicare.
The proposal said insurers should determine their rates based on an anticipated per capita Medicare Advantage growth rate of negative 3.55 percent. It was not immediately clear how this and other measures in the document would translate into payment levels for insurers.
The proposed payment rates are a key factor in how insurance companies plan their business for the coming year, including in which markets they will offer health plans, what their medical and administrative costs will be and at what level to set premiums and doctor visit co-payments.