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

Amy Harder, author of Generate
19 mins ago - Energy & Environment

Climate change goes mainstream in presidential debate

Photo illustration: Aïda Amer/Axios. Photo: Olivier Douliery-Pool/Getty

The most notable part of Thursday’s presidential debate on climate change was the fact it was included as a topic and assumed as a fact.

The big picture: This is the first time in U.S. presidential history that climate change was a featured issue at a debate. It signals how the problem has become part of the fabric of our society. More extreme weather, like the wildfires ravaging Colorado, is pushing the topic to the front-burner.

Finally, a real debate

Photo: Morry Gash/AP

A more disciplined President Trump held back from the rowdy interruptions at tonight's debate in Nashville, while making some assertions so outlandish that Joe Biden chuckled and even closed his eyes.

  • A Trump campaign adviser told Axios: "He finally listened." 

The result: A real debate.

Biden to Trump: "I have not taken a penny from any foreign source ever in my life"

Former VP Joe Biden pushed back Thursday against allegations from President Trump, saying he had never profited from foreign sources. "Nothing was unethical," Biden told debate moderator Kristen Welker about his son Hunter's work in Ukraine while he was vice president.

Why it matters: Earlier on Thursday, Hunter Biden's former business partner, Tony Bobulinski, released a statement saying Joe Biden's claims that he never discussed overseas business dealings with his son were "false."