Health Affairs February 24, 2022
Health Affairs Forefront has published articles that advance two diametrically opposing assessments of issues regarding the Medicare Advantage (MA) program. In September 2021, Donald Berwick and Richard Gilfillan (B-G) argued that mounting MA overpayments, many from plan efforts to get physicians to code more diagnoses when they see a patient, simultaneously threaten Medicare’s fiscal soundness and health care delivery; for them, this “MA money machine” is reflected in the extremely high valuations obtained by start-up insurance companies focused on MA and primary-care physician practices that specialize in contracting with MA plans.
In his January 2022 response, George Halvorson (GH) categorically disputes many of the key B-G points, which he views as attacking the fundamentals underpinning MA, including the use of...
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