Healthcare Finance News July 6, 2023
The concern is that the QBP overpays MA organizations and does not encourage quality improvement or help beneficiaries select plans.
The Medicare Advantage quality bonus program, established by the Affordable Care Act as part of a package of MA reforms, was expected to reduce payments to MA organizations. But according to a new Urban Institute report, the expected cost savings from the reforms have not materialized.
In part, this is because more than half of MA plans are now receiving bonuses for “high performance” on the star ratings measures that underlie the QBP. Unlike other Medicare pay-for-performance programs, the QBP is upside-only, meaning it does not assess penalties on low-performing MA contracts.
The concern is that the QBP overpays MA...
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