The effective payment growth rate is higher
CMS mentioned that the effective payment growth rate for 2022 would be 4.55%, but it quickly jumped to 5.59% in the final rule, resulting in a 4.08% increase in revenue. But this is something good for MA organizations, It indicates that CMS won’t be expecting a huge cost rebound after the major drop, due to foregone care.
However, we shouldn’t jump to conclusions and assume that health plans will remain complacent. Contract bids to CMS need to be based on the most current and accurate Hierarchical Condition Category (HCC) data available. If some plan members have been trying to avoid in-person care, such as their annual wellness Visits, for a year or more, the risk of new care gaps or chronic conditions will increase.