Managed Care Mag February 14, 2019
Timothy Kelley

Is MA a ripoff of taxpayers, a godsend for integrated, cost-effective care, or somehow both? You can’t take a stand on this question from 30,000 feet. So let us guide you through the valley of details.

In an old joke, a man sprinkles a magic powder to ward off elephants. “But there are no elephants around here!” protests a skeptic.

“You see?” says the man. “It works!”

In one sense, the funding of Medicare Advantage (MA) clearly works. Insurers are flocking to offer these privately managed plans, through which a growing share of Medicare enrollees—in 2018, it was 34%—choose to get their benefits. When companies contract with CMS to offer an MA plan, they receive monthly capitated payments for enrollees,...

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