Profits, medical loss ratios, and the ownership structure of Medicare Advantage plans

There is a great deal of controversy and uncertainty regarding profits in the Medicare Advantage (MA) program. Interest in these issues is growing as the share of beneficiaries grows. The Medicare Payment Advisory Commission, or MedPAC, recently reported that MA enrollment grew 10% from July 2020 to July 2021. This means MA accounted for 46% of all Medicare beneficiaries in 2021, with payments to MA plans totaling $350 billion. A recent visible exchange of facts and interpretations of some data by Berwick and Gilfillan, Halvorson, Crane, and Ginsburg and Lieberman has highlighted how incomplete existing data are and how that limits the ability to arrive at conclusions about market performance. The debate is focused on whether...