AJMC December 2, 2021
In a local market with multiple accountable care organizations and multiple Medicare Advantage plans, how do we administratively set rates that are localized enough so that they do not drive consolidation?
Michael McWilliams, Alice Chen, and Michael Chernew recently articulated the next frontier in total cost of care accountability: Eventually, there will not be a pure fee-for-service (FFS) comparison. In several counties in the country, this may already be the case. The combination of Medicare Shared Savings Program (MSSP) penetration and Medicare Advantage (MA) penetration is high enough that there is no longer a significant population of Medicare beneficiaries for whom neither health care providers nor MA plans are accountable for the total cost of care. Arriving at this desirable...
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