Healthcare DIVE January 26, 2018
Dive Brief:
- Some enrollees in Medicare Advantage plans are paying higher premiums due to a distortion in the way CMS determines payment for the plans, a new Health Affairs analysis finds.
- MA payment is based on county-level benchmarks that average Medicare’s per capita fee-for-service costs for Part A and Part B and then add them together. When beneficiaries opt out of Part B, that skews the cost measure, resulting in lower payment rates.
- To remedy the problem, CMS should base MA benchmarks on fee-for-service costs for beneficiaries enrolled in both Part A and Part B only, the authors say.
Dive Insight:
A review of 2015 Medicare claims found Part A per capita costs for beneficiaries enrolled in both...
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