The year 2024 brings significant policy and technical changes for Medicare Advantage and Medicare Prescription Drug. These changes will affect millions of beneficiaries, providers, and health plans. In this article, we will discuss the key changes that will come into effect in 2024, and how they will impact the Medicare Advantage and Prescription Drug programs.
Changes in Medicare Advantage
MA Star Ratings
- The Centers for Medicare and Medicaid Services (CMS) will make changes to the MA Star Rating system. The new system will include new measures, such as telehealth access, care coordination, and patient safety, to better reflect the quality of care provided by MA plans.
- CMS will allow MA plans to offer more flexibility in their benefits packages. This will allow plans to tailor their benefits to the specific needs of their beneficiaries. For example, plans may offer more benefits for chronic conditions, such as diabetes or heart disease.
- CMS will expand telehealth services for MA beneficiaries. This will include virtual visits with healthcare providers, as well as remote patient monitoring for chronic conditions. The goal is to improve access to care and reduce costs for beneficiaries.
Changes in Medicare Prescription Drug
Medicare Prescription Drug (Part D) provides coverage for prescription drugs to Medicare beneficiaries. The following changes are expected to take place in 2024 for Part D:
The 2024 policy and technical changes for Medicare Advantage and Medicare Prescription Drug are set to bring about important improvements to the programs. The changes in MA include a more robust Star Rating system, greater benefit flexibility, and increased access to telehealth services. The changes in Part D will establish a new out-of-pocket maximum, allow for drug price negotiation, and implement measures to address the opioid crisis.
- CMS will establish a new maximum limit on out-of-pocket costs for Part D beneficiaries in 2024. This limit will help to reduce the financial burden on beneficiaries who require expensive prescription medications. Once beneficiaries have reached the out-of-pocket maximum, they will no longer be responsible for any additional costs for their covered prescription drugs for the remainder of the year. This change will provide more financial security and relief to those who have high prescription drug costs.
Drug Price Negotiation
- Starting in 2024, CMS will permit Part D plans to negotiate with pharmaceutical companies for lower drug prices. This new provision will give the plans more bargaining power, which could result in reduced drug prices for Medicare beneficiaries. Currently, drug prices for Medicare beneficiaries can be significantly higher than for those with private insurance. Allowing Part D plans to negotiate drug prices may help to reduce this disparity and provide cost savings to beneficiaries.
- To combat the opioid crisis, CMS will introduce new measures starting in 2024. These measures will include limits on the number of opioids that can be prescribed, an increase in access to medication-assisted treatment, and an expansion of drug disposal programs. These efforts aim to decrease the number of opioid-related deaths and improve the overall health and well-being of Medicare beneficiaries. By limiting the number of opioids prescribed, CMS hopes to reduce the potential for addiction and abuse, while increasing access to treatment and drug disposal programs will help those struggling with opioid addiction get the help they need. These measures are an important step toward addressing the ongoing opioid epidemic in the United States.
The 2024 policy and technical changes for Medicare Advantage and Medicare Prescription Drug will have a significant impact on beneficiaries, providers, and health plans. These changes will provide more flexibility, improved access to care, and potentially lower costs for beneficiaries. As healthcare industry experts, we recommend that beneficiaries stay informed about these changes and speak with their healthcare providers to ensure they are receiving the best possible care for their individual needs. By staying informed and engaged in their healthcare, beneficiaries can take advantage of these changes and improve their overall health and well-being.