Medicare Advantage Plans Changes which are being brought in 2022

The biggest concern is the health of any person. Since the arrival of the covid 19 viruses, patients have to take treatment for a longer time than other diseases, for which they have to stay in the hospital. Looking at the pandemic, healthcare costs can go from $75 billion to $575 billion. With the advent of the pandemic, costs have dropped dramatically, leaving Medicare Advantage organizations facing a financial challenge. Although no one was aware of this virus, there has been a lot of loss due to uncertainty, but now Medicare advantage plans 2022 are being made by Medicare advantage organizations for the coming time.

The rules set out by Medicare Advantage for the year 2022 have been finalized.

Payment growth rate

In the advance notice rules, CMS has made an effective payment growth plan for 2022, which was 4.55% earlier, but after some changes, it has been finalized to 5.59%. The result will increase the revenue by 4.08%, which is an excellent sign for the Medicare Advantage Organization. But it indicates here that the CMS is not expecting much movement in the price after this uncertainty and fall. However, this does not mean that the health care plans that have been made can remain unsatisfied. CMS has made these plans keeping in view the current situation and hierarchical data.

New risk methodology

Payment growth is expected to be higher in 2022, but a few payers may offset this increased revenue because some changes have been made in calculating risk adjustment factors. A few years back, it was announced that the score of the Risk Adjustment Factor would be based on the data of the Encounter Data System, 100%. As a result, there will be a service claim fee instead of a blend of encounter data and risk adjustment processing system

This will be pretty challenging for Medicare Advantage plans as they will have to come out with an accurate score from the incomplete data. Encouraging your members to manage chronic conditions and prevent risk can probably improve accuracy. In addition, the Medicare Advantage Organization should go to those who are experienced in the technical requirements so that the medicare advantage organization can calculate the data accurately.


In the year 2022, everyone has used telehealth, seniors and experienced it too. 60% of Medicare benefits that provided regular reports also primarily took telehealth appointments. 82% of seniors reported access to the Internet, and 91% of Medicare Health members described telehealth as a favourable experience, increasing its adoption rate. The Medicare Payment Rules were changed in the early pandemic, and the Medicare Advantage Organization moved it to the final rules for 2022. Encouraging telehealth utilization is very important as seniors in today’s time better check on telehealth by getting their patients in person.

Last words 

There has been a lot of loss due to the uncertain pandemic everywhere, but to emerge from it, the Medicare advantage organization has made Medicare advantage plans 2022. Telehealth has also been heavily promoted and has been recognized as a favorite by many seniors.