Lexology September 23, 2024
In March 2024, the Medicare Payment Advisory Commission (MedPAC) released its report to Congress (Report) that addressed, among other topics, the increasing cost of Medicare Managed Care (MA).
The Report acknowledges that aggregate Medicare payments to MA plans have always been higher than Medicare estimates of the amount Medicare would have paid for the same beneficiaries under Fee-For-Service (FFS) Medicare. In 2024, MedPAC estimates that Medicare will spend an additional $83 billion in payments to MA plans compared to that which Medicare would have paid for those same beneficiaries if they had FFS Medicare coverage.
Coding
In the Report, MedPAC theorizes that this increased cost may be attributed, in large part, to coding differences that result in risk scores about...
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