“Are Payments To Medicare Advantage Plans Inflated?”

“Are Payments To Medicare Advantage Plans Inflated?,” by Kenneth E. Thorpe, Health Affairs 

“The most recent March 2022 MedPAC report (chapter 12) concludes that Medicare pays 4 percent more for the same patient in Medicare Advantage compared to traditional Medicare. This conclusion is reached by comparing the level and growth in risk scores (CMS-HCC) between the two programs. MedPAC reports higher growth in risk scores in the Medicare Advantage program than found in traditional Medicare. This framework, however, ignores the fundamentally different approaches Medicare takes in paying for fee-for-service encounters on the one hand and making payments to Medicare Advantage plans based on annual expected Medicare spending on the other. To truly compare spending under Medicare Advantage versus fee-for-service Medicare would require a more careful and extensive approach than MedPAC employs; I outline what the needed approach would look like below.”

 

LTC Comment, Stephen A. Moses, President, Center for Long-Term Care Reform:

Could it be that Medicare Advantage is not quite the evil, money grubbing, rip-off it’s often made out to be? This is a very thoughtful and rare articulation and analysis from a more objective, less ideological point of view.