“The CMS currently calculates MA payments based on fee-for-service Part A spending, which covers hospital care, and Part B, which covers more routine care such as doctors’ visits.  Health plans that offer Medicare Advantage cover both parts. Medicare fee-for-service does not mandate participation in both parts. That means the current formula for determining rates underestimates spending, resulting in plans potentially being underpaid.  To address this issue, MedPAC is recommending that the HHS secretary alter the current formula to be based only on fee-for-service spending data for beneficiaries enrolled in both Part A and Part B.  Plans, not surprisingly, lauded MedPAC’s recommendation.”

LTC Comment (from Stephen A. Moses, President, Center for Long-Term Care Reform):
MedPAC, often a scourge to Medicaid LTC providers, won’t get complaints from Medicare Advantage companies for this proposed policy. 

Health plans could see up to $10 billion more from Medicare Advantage

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