Does Medicare Advantage Cost Less Than Traditional Medicare?
نویسندگان
چکیده
The costs of providing benefits to enrollees in private Medicare Advantage (MA) plans are slightly less, on average, than what traditional Medicare spends per beneficiary in the same county. However, MA plans that are able to keep their costs comparatively low are concentrated in a fairly small number of U.S. counties. In the 25 counties where the cost differences between MA plans and traditional Medicare are largest, MA plans spent a total of $5.2 billion less than what traditional Medicare would have been expected to spend on the same beneficiaries, with health maintenance organizations (HMOs) accounting for all of that difference. In the rest of the country, MA plans spent $4.8 billion above the expected costs under traditional Medicare. Broad determinations about the relative efficiency of MA plans and traditional Medicare can therefore be misleading, as they fail to take into account local conditions and individual plans' performance.
منابع مشابه
Steps to reduce favorable risk selection in medicare advantage largely succeeded, boding well for health insurance exchanges.
Within Medicare, the Medicare Advantage program has historically attracted better risks-healthier, lower-cost patients-than has traditional Medicare. The disproportionate enrollment of lower-cost patients and avoidance of higher-cost ones during the 1990s-known as favorable selection-resulted in Medicare's spending more per beneficiary who enrolled in Medicare Advantage than if the enrollee had...
متن کاملMedicare beneficiaries less likely to experience cost- and access-related problems than adults with private coverage.
The experiences of people covered by Medicare and those with private employer insurance can help inform policy debates over the federal budget deficit, Medicare's affordability, and the expansion of private health insurance under the Affordable Care Act. This article provides evidence that people with employer-sponsored coverage were more likely than Medicare beneficiaries to forgo needed care,...
متن کاملDoes Risk Adjustment Reduce Selection in the Private Health Insurance Market? New Evidence from the Medicare Advantage Program
Views expressed here are those of the authors and not of the institutions with which they are affiliated. Abstract Roughly 25 percent of Medicare beneficiaries are enrolled in a private Medicare Advantage plan, a fraction that has been growing steadily in recent years. Because these plans are " at risk " for the cost of their enrollees' care, they have an incentive to attract and retain differe...
متن کاملThe continuing cost of privatization: extra payments to Medicare Advantage plans jump to $11.4 billion in 2009.
The Medicare Modernization Act of 2003 explicitly increased Medicare payments to private Medicare Advantage (MA) plans. As a result, MA plans have, for the past six years, been paid more for their enrollees than they would be expected to cost in traditional fee-for-service Medicare. Payments to MA plans in 2009 are projected to be 13 percent greater than the corresponding costs in traditional M...
متن کامل“UPCODING” PROBLEM EXACERBATES OVERPAYMENTS TO MEDICARE ADVANTAGE PLANS Administration Action and House Health Reform Bill Seek to Address Problem
Private plans were brought into Medicare on the theory that they could deliver Medicare services at lower cost. However, the Medicare Payment Advisory Commission (MedPAC) — Congress’s expert advisory body on Medicare payment policy — has found that Medicare pays private plans 14 percent more than it costs to treat the same beneficiaries in the traditional Medicare program. These overpayments th...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Issue brief
دوره 2 شماره
صفحات -
تاریخ انتشار 2016