Health Affairs July 1, 2024
In a recent Forefront article, two current and two former members of the Medicare Payment Advisory Commission (MedPAC) challenge the Commission’s estimate that favorable selection and upcoding increase payments to Medicare Advantage (MA) plans in 2024 by $83 billion over what Medicare would have spent if MA beneficiaries had remained in traditional Medicare (TM). The authors mischaracterize MedPAC’s upcoding and favorable selection findings; they also shift to discussing the value of MA from the perspective of “a holistic policy future for Medicare,” rather than analyzing MedPAC’s work on the dollars and cents of MA overpayments. After identifying several important areas where we agree with the authors—Brian DeBusk, Brian Miller, Craig Samitt, and Kenny Kan (DMSK)—we explain why many of their...
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