Medicare Advantage or disadvantage? Lawmakers hear about the good, the bad, and the prior authorizations

Medical Economics July 24, 2025
Richard Payerchin, Todd Shryock

Key Takeaways

Medicare Advantage offers additional benefits but faces criticism for prior authorization issues, payment delays, and higher costs compared to traditional Medicare.
Congressional leaders emphasize the need for transparency, modernized benefits, and aligned incentives to maintain trust and efficiency in the Medicare Advantage program.
Witnesses highlight the importance of patient-centered care, reduced administrative burdens, and better oversight to address financial and operational challenges in Medicare Advantage.
Critics argue that Medicare Advantage is more expensive for taxpayers, with calls for reforms to align payments with traditional Medicare costs and improve coding intensity adjustments.

House hearing includes witness testimony about patient care, financial costs, and what needs changing.

Medicare Advantage is a popular program with patients, but prior authorizations...

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