Medicare Advantage Quality Bonus Program Overpays Insurers, Needs Reform

KEY TAKEAWAYS

A report by the Urban institute looks at the role of the quality bonus program in the Medicare Advantage payment system and finds it results in overpayments to insurers.

Issues with measures of beneficiary experience and administrative effectiveness, as well as the star rating system suffering from score inflation, show that the quality bonus program needs overhauling.

Researchers suggest reforms that focus on protecting beneficiaries from poor plan administration, while performance reforms should include low-performing contracts being assessed penalties.