Healthcare DIVE September 6, 2023
Favorable selection of healthier beneficiaries led to overpayments in counties with high Medicare Advantage penetration, but benchmark changes could mitigate the impact.
Dive Brief:
- Favorable selection of beneficiaries in Medicare Advantage is throwing off benchmarks used to set payments to those plans, resulting in billions of overpayments to the privatized insurance program for seniors, according to a study published this week in Health Affairs.
- Healthier people are more likely to enroll in MA compared to traditional Medicare, leading to overpayment in counties with high levels of MA participation and underpayment in counties with less MA market penetration, the study found.
- Overall, MA plans were overpaid by an average of $9.3 billion per year between 2017 and 2020. As...
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