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CMS-1403-FC TABLE 38: Average Number of Medicare Part B Fee-for-service Enrollees from CY 2008 to CY 2009 (excluding beneficiaries enrolled in MA plans) 2008 2009 Overall 41.662 million 42.425 million Medicare Advantage (MA) 9.592 million 10.431 million Net 32.070 million 31.995 million Percent Increase -0.2 percent An important factor affecting fee-for-service enrollment is beneficiary enrollment in Medicare Advantage (MA) plans. Because it is difficult to estimate the size of the MA enrollee population before the start of a CY, at this time we do not know how actual enrollment in MA plans will compare to current estimates. For this reason, the estimate may change substantially as actual Medicare fee-for-service enrollment for CY 2009 becomes known. ● Factor 3--Estimated Real Gross Domestic Product Per Capita Growth in 2009 We estimate that the growth in real GDP per capita from CY 2008 to CY 2009 will be 1.2 percent (based on the 10-year average GDP over the 10 years of 2000 through 2009). Our past experience indicates that there have also been changes in estimates of real per capita GDP growth made before the year begins and the actual change in GDP computed after the year is complete. Thus, it is possible 966
CMS-1403-FC that this figure will change as actual information on economic performance becomes available to us in 2009. ● Factor 4--Percentage Change in Expenditures for Physicians' Services Resulting From Changes in Statute or regulations in CY 2009 Compared With CY 2008 The statutory and regulatory provisions that will affect expenditures in CY 2009 relative to CY 2008 are estimated to have an impact on expenditures of 4.2 percent. These include the DRA provision reducing payments for imaging services, the MMSEA provision regarding the PQRI bonuses payable in 2009, and the MIPPA provisions regarding the change in cost sharing for mental health services, the physician update, and the change in application of BN to the CF. The details of the MIPPA provisions are discussed in section III. of this final rule with comment period. 2. Detail on the 2008 SGR A more detailed discussion of our revised estimates of the four elements of the 2008 SGR follows. ● Factor 1--Changes in Fees for Physicians' Services (Before Applying Legislative Adjustments) for 2008 This factor was calculated as a weighted-average of the 2008 changes in fees that apply for the different types of services included in the definition of physicians' services for the SGR. 967
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<strong>CMS</strong>-1403-FC<br />
TABLE 38: Average Number of Medicare Part B<br />
Fee-for-service Enrollees from CY 2008 to CY 2009<br />
(excluding beneficiaries enrolled in MA plans)<br />
2008 2009<br />
Overall 41.662 million 42.425 million<br />
Medicare Advantage (MA) 9.592 million 10.431 million<br />
Net 32.070 million 31.995 million<br />
Percent Increase -0.2 percent<br />
An important factor affecting fee-for-service<br />
enrollment is beneficiary enrollment in Medicare Advantage<br />
(MA) plans. Because it is difficult to estimate the size<br />
of the MA enrollee population before the start of a CY, at<br />
this time we do not know how actual enrollment in MA plans<br />
will compare to current estimates. For this reason, the<br />
estimate may change substantially as actual Medicare<br />
fee-for-service enrollment for CY 2009 becomes known.<br />
● Factor 3--Estimated Real Gross Domestic Product Per<br />
Capita Growth in 2009<br />
We estimate that the growth in real GDP per capita<br />
from CY 2008 to CY 2009 will be 1.2 percent (based on the<br />
10-year average GDP over the 10 years of 2000 through<br />
2009). Our past experience indicates that there have also<br />
<strong>been</strong> changes in estimates of real per capita GDP growth<br />
made before the year begins and the actual change in GDP<br />
computed after the year is complete. Thus, it is possible<br />
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