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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

6 hours ago - Politics & Policy

McConnell drops filibuster demand, paving way for power-sharing deal

Senate Majority Leader Chuck Schumer (R) and Minority Leader Mitch McConnell attend a joint session of Congress. Photo: Olivier Douliery/AFP via Getty Images

Senate Minority Leader Mitch McConnell has abandoned his demand that Democrats state, in writing, that they would not abandon the legislative filibuster.

Between the lines: McConnell was never going to agree to a 50-50 power sharing deal without putting up a fight over keeping the 60-vote threshold. But the minority leader ultimately caved after it became clear that delaying the organizing resolution was no longer feasible.

7 hours ago - Technology

Scoop: Google won't donate to members of Congress who voted against election results

Sen. Ted Cruz led the group of Republicans who opposed certifying the results. Photo: Stefani Reynolds/Pool/AFP via Getty Images

Google will not make contributions from its political action committee this cycle to any member of Congress who voted against certifying the results of the presidential election, following the deadly Capitol riot.

Why it matters: Several major businesses paused or pulled political donations following the events of Jan. 6, when pro-Trump rioters, riled up by former President Trump, stormed the Capitol on the day it was to certify the election results.

8 hours ago - Politics & Policy

Minority Mitch still setting Senate agenda

Illustration: Aïda Amer/Axios

Chuck Schumer may be majority leader, yet in many ways, Mitch McConnell is still running the Senate show — and his counterpart is about done with it.

Why it matters: McConnell rolled over Democrats unapologetically, and kept tight control over his fellow Republicans, while in the majority. But he's showing equal skill as minority leader, using political jiujitsu to convert a perceived weakness into strength.