AJMC November 11, 2024
Maggie L. Shaw

Key Takeaways

  • Medicare-eligible veterans often enroll in MA plans but primarily use VHA services, causing federal spending inefficiencies.
  • Wasteful MA spending rose from $838 million in 2016 to $1.32 billion in 2020 due to unused Medicare services.
  • High-veteran MA plans, with over 20% veteran enrollment, contribute significantly to this inefficiency.
  • Recommendations include refining CMS payment models and considering reimbursement policies for VHA plan spending from MA plans.

This research is not the first to uncover duplicative and wasteful spending on health care for veterans who receive care primarily through the Veterans Health Administration as they are also enrolled in Medicare Advantage plans.

Despite automatically receiving health care coverage through the Veterans Health Administration (VHA), many Medicare-eligible veterans continue...

Today's Sponsors

LEK
ZeOmega

Today's Sponsor

LEK

 
Topics: Insurance, Medicare Advantage, Provider, Survey / Study, Trends, VA / DoD
Rural hospitals' financial pressures mount as Medicare Advantage grows: 12 things to know
With Amedisys Case Ongoing, DOJ Reportedly Also Investigating UHG’s Medicare Advantage Billing
Medicare Advantage plans are hurting rural hospitals: Report
UnitedHealth's rough stretch continues, with buyouts, a reported DOJ probe and a 23% drop in three months
Managed Care Reflections: Insights From Richard J. Gilfillan, MD; and Donald M. Berwick, MD, MPP

Share This Article