To Strengthen Primary Care, Harmonize Medicare Advantage And Traditional Medicare Payment Policies

Health Affairs July 14, 2023
Howard Haft, Eli Y. Adashi

Medicare beneficiaries rely on their primary health care providers to address the majority of their health care needs. Medicare, funded with taxpayer dollars, compensates primary health care providers for their services directly through traditional Medicare or indirectly through Medicare Advantage (MA) plans depending on which type of coverage individual beneficiaries have chosen.

In this article, we identify a unique opportunity for the Centers for Medicare and Medicaid Services (CMS) and MA plans to harmonize and modernize their primary care payment framework for better and more efficient care. We also describe how they might avoid the perils to providers and beneficiaries that may result from failing to recognize looming payment issues.

MA was born from a federal policy intent on bringing...

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