Modernizing Medicare Fee-for-Service Cost-Sharing Has Trade Offs
Health Payer Intelligence February 13, 2018
Medicare’s current fee-for-service cost-sharing design is flawed, but modernizing the current design could create trade-offs in beneficiary costs, says GAO.
Medicare’s fee-for-service (FFS) cost-sharing design requires modernization to protect beneficiaries from catastrophic costs, but changing the current design may bring new financial concerns, a new GAO report found.
In 2015, eighty-one percent of Medicare beneficiaries receiving care in the FFS environment obtained supplemental coverage to avoid burdensome cost-sharing amounts. Beneficiaries are likely to experience financial strain as they begin to pay multiple premiums for multiple health plans.
GAO also found that a lack of cost-sharing spending caps caused a small percentage of beneficiaries to experience significant catastrophic healthcare costs.
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