Health Payer Intelligence July 11, 2023
A reformed Medicare Advantage quality bonus program should penalize contracts for poor performance and determine plan quality at the local level.
The Medicare Advantage quality bonus program overpays plans and does not effectively promote quality care, indicating that program reforms are needed, according to an Urban Institute report.
The quality bonus program uses the star rating system to measure performance across Medicare Advantage contracts. Contracts with high star ratings receive higher benchmarks and rebate percentages than other low-star contracts in the same area. The program does not financially penalize low-performing contracts.
Researchers reviewed 2023 Medicare Advantage star ratings and enrollment data to assess the quality bonus program and how it impacts the Medicare Advantage payment system. They discovered several problems...
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