Healthcare DIVE June 14, 2023
Emily Olsen

Dive Brief:

  • Overpayments to Medicare Advantage plans could reach more than $75 billion this year — almost triple prior estimates — highlighting the need for payment reform to avoid overtaxing the Medicare system, according to researchers from the USC Schaeffer Center for Health Policy and Economics.
  • That’s a result of favorable selection, as millions of beneficiaries who switch from traditional fee-for-service Medicare to MA have lower spending than the beneficiaries who stay, researchers said.
  • USC Schaeffer argued for two potential ways to improve rate setting: unlinking MA payments from fee-for-service spending or enacting a system for competitive bidding by MA plans.

Dive Insight:

More seniors are choosing MA plans, where private insurers contract with the government...

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Topics: CMS, Govt Agencies, Insurance, Medicare Advantage, Provider, Survey / Study, Trends
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