Life Science Leader June 22, 2018
As Congress grapples with complex ways to provide greater care coordination for seniors with multiple chronic conditions and value-based reimbursement schemes for prescription drugs, an obvious solution is being fundamentally ignored: greater enrollment in Medicare Advantage (MA).
MA plans offer comprehensive coverage of all medical goods and services at a capitated rate. They include all types of health plans: private insurance, HMO, and preferred provider organizations. These plans have every incentive to keep their enrolled patients healthy. They are experimenting with innovative risk-sharing arrangements with providers, from upside-only bonus contracts to fully delegated risk and capitation.
Enrollment in MA has steadily increased from 5.3 million beneficiaries in 2005 (comprising 13 percent of the population) to 19 million in 2017 (comprising...
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