AXIOS June 14, 2023
Overpayments to insurers administering Medicare Advantage plans now exceed $75 billion a year due to aggressive coding of patients’ health conditions and easily-achieved bonus payments tied to quality, researchers with the USC Schaeffer Center for Health Policy & Economics found.
Why it matters: More seniors are choosing private Medicare Advantage plans over traditional Medicare, and continued overpayments could threaten the long-term viability of the program.
What they found: Researchers said the excess amounts are higher than previously recognized, noting that beneficiaries that flock to private Medicare plans have significantly lower expenditures than those with similar risk factors who remain in traditional Medicare.
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