GAO Sees Tradeoffs in Medicare FFS Cost-sharing Updates

HealthLeaders Media February 9, 2018
John Commins

Congress asked GAO to examine the effects on beneficiaries’ costs if Medicare’s fee-for-service cost-sharing included a single deductible, uniform coinsurance above the deductible, and an annual cap.

Modernizing and simplifying Medicare fee-for-service cost-sharing designs so that they resemble private plans is doable, but it comes with trade-offs, a Government Accountability Office study shows.

Congress asked GAO to examine the annual and multiyear effects on beneficiaries’ costs if Medicare FFS cost-sharing included a single deductible, uniform coinsurance above the deductible, and an annual cap.

GAO calculated the distribution of 28 million beneficiaries’ one-year, four-year, and eight-year annual cost-sharing responsibilities—including the median and maximum responsibility—under the current cost-sharing design and each of the four illustrative designs, compared these distributions, and found that:

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