loading…
loading…
loading…
13
Attachment II. Key Assumptions and Financial Information The USPCCs are the basis for the National Per Capita MA Growth Percentage. Below is a table that compares last year’s estimates of USPCCs with current estimates for 2003 to 2027. In addition, this table shows the current projections of the USPCCs through 2028. We are also providing a set of tables that summarize the key Medicare assumptions used in the calculation of the USPCCs. Most of the tables include information for the years 2003 through 2028. Most of the tables in this attachment present combined aged and disabled non-ESRD data. The ESRD information presented is for the combined aged-ESRD, disabled-ESRD, and ESRD only. All of the information provided in this attachment applies to the Medicare Part A and Part B programs. Caution should be employed in the use of this information. It is based upon nationwide averages, and local conditions can differ substantially from conditions nationwide. None of the data presented here pertain to the Medicare Part D prescription drug benefit. On March 12, 2025, CMS announced an earlier termination schedule for several Innovation Center models. CMS aims to conclude the Maryland Total Cost of Care, Primary Care First, ESRD Treatment Choices, and Making Care Primary models by December 31, 2025. The geographic adjustments for the five year historical experience period (2019-2023) used for CY 2026 ratebook development are unaffected by the earlier model terminations. Given the time constraints of the statutory announcement of the CY 2026 MA rates and the timing of the model termination announcement, we have not assessed whether the earlier model terminations would impact the assumptions used for USPCC projections for 2026 and thereafter. As such, we expect that any impacts on USPCC assumptions will be first incorporated in the CY 2027 Advance Notice. Table II-1. Comparison of Current & Previous Estimates of the Total USPCC – non-ESRD Part A Part B Part A + Part B Calendar year Current estimate Last year’s estimate Current estimate Last year’s estimate Current estimate Last year’s estimate Ratio 2003 $296.18 $296.18 $247.66 $247.66 $543.84 $543.84 1.000 2004 314.08 314.08 271.06 271.06 585.14 585.14 1.000 2005 334.83 334.83 292.86 292.86 627.69 627.69 1.000 2006 345.30 345.30 313.70 313.70 659.00 659.00 1.000 2007 355.44 355.44 330.68 330.68 686.12 686.12 1.000 2008 371.90 371.90 351.04 351.04 722.94 722.94 1.000 2009 383.91 383.91 367.49 367.49 751.40 751.40 1.000 2010 383.93 383.93 376.34 376.34 760.27 760.27 1.000 2011 387.73 387.73 385.30 385.30 773.03 773.03 1.000 2012 377.37 377.37 391.96 391.93 769.33 769.30 1.000