Overpayments to Medicare Advantage plans could exceed $75 billion in 2023


Medicare Advantage plan enrollment surpassing traditional Medicare

Improving accuracy of Medicare Advantage rate setting

  • Reform the current payment approach linking plan rates to average spending by traditional Medicare beneficiaries. This could include measures to reduce the impact of aggressive coding by plans and mandating new data reporting requirements for Medicare Advantage plans to improve accuracy, completeness, and comparability of the data to make it akin to claims data in traditional Medicare.
  • Abandon the current approach and institute competitive bidding by Medicare Advantage plans. This option could use market forces to determine what Medicare pays Medicare Advantage plans with the aim of capturing efficiency gains for taxpayers instead of higher benefits or profits for Medicare Advantage plans.

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