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Jim Cole / AP

Medicare Advantage and Part D payment rates will increase by 0.45% on average for 2018, barely above the 0.25% that the Centers for Medicare and Medicaid Services proposed in February. The average rate will go up by 2.95% after estimating how health insurers and pharmacy benefit managers code the health risks of their Medicare members, CMS said Monday.

Between the lines: Not much changed between the final 2018 guidance and the proposal for Medicare Advantage, which spends about $200 billion per year. This was the last Medicare policy document from the Obama administration, and President Trump's team didn't have a lot of time to make its own changes. But the 185-page final notice contains some wins for the insurance industry.

  • Encounter data. This one is wonky and involves how CMS calculates risk scores, which describe how sick a Medicare member is. A higher risk score means the person is sicker, and consequently the government pays the health plan more. For 2018, CMS will pay out risk scores based 15% on encounter data (which are supposed to be more accurate claims data) instead of the proposed 25%.
  • Why it matters: Insurers don't want to use encounter data at all, arguing the data aren't ready to be used, but a reduction in the proposed blend still helps their payments.
  • Retiree Medicare Advantage plans. No change from the proposal, which means payments to Medicare Advantage plans sponsored by employers won't be capped by the government. Instead, the government will use a blended rate next year and will ask for input again on this for 2019.
  • Why it matters: The industry wanted this proposal dumped completely — they'd just as soon have no limits at all, either through caps or blended rates. Employer Medicare Advantage plans are profitable, and administratively setting rates would erode those profits.

Go deeper

5 hours ago - World

Biden seeks to reboot U.S. sanctions policy

Sanctions increased under Obama and dramatically under Trump. Photo: Tom Williams/CQ Roll Call

The Biden administration is rethinking the U.S. approach to sanctions after four years of Donald Trump imposing and escalating them.

The big picture: Sanctions are among the most powerful tools the U.S. has to influence its adversaries’ behavior without using force. But they frequently fail to bring down regimes or moderate their behavior, and they can increase the suffering of civilians and resentment of the U.S.

5 hours ago - World

Merkel's farewell spoiled by Poland crisis at EU summit

One last awkward EU "family photo." Photo: John Thys/AFP via Getty Images

Angela Merkel took up her vaunted mantle as Europe's crisis manager for what could be the last time tonight, as she urged the EU to find compromise in its showdown with Poland.

Why it matters: The European Commission has threatened to withhold over $40 billion in pandemic recovery funds after Poland's constitutional tribunal — stacked with loyalists from the ruling right-wing populist party — rejected the principle that EU law has primacy over national law.

Republicans who put it all on the line

Rep. Nancy Mace speaks with reporters after voting to hold Steve Bannon in contempt of Congress. Photo: Anna Moneymaker/Getty Images

A small contingent of House Republicans risked their political futures on Thursday, they say, in the name of constitutional responsibility.

Why it matters: The nine Republicans who voted to hold former Trump aide Steve Bannon in contempt of Congress are now in peril of becoming political pariahs. They've opened themselves up to potential primary challengers and public attacks from their party's kingmaker — former President Trump.