2026 Final Rate Notice Offers Medicare Advantage Course Correction, Experts Say
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Apr 11, 2025
Reflecting the addition of more recent fee-for-service (FFS) Medicare cost data in its estimates, CMS on April 7 projected that Medicare Advantage plans can expect to see upwards of 5% greater pay next year. After nearly a week of stock market mayhem due to concerns about U.S.-imposed tariffs, major insurers’ stocks soared on the news that an estimated $25 billion in extra MA funds may be available next year. To industry insiders, however, this isn’t necessarily a “rescue” (as Barron’s put it) or a confirmation that the Trump administration is all in on MA.
The news was released as part of CMS’s Announcement of Calendar Year (CY) 2026 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies, an annual notice that must be published by the first Monday in April. The preliminary version of that notice, the 2026 Advance Notice, was released on Jan. 10 by CMS under President Joe Biden. The Biden administration estimated an average change in revenue of 2.23%, or an all-in estimate of 4.33% when accounting for an average risk score increase of 2.10%.
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