June 14, 2023
Payers | Tea Leaves
  • Overpayments to insurers administering Medicare Advantage plans now exceed $75 billion a year due to aggressive coding of patients’ health conditions and easily achieved bonus payments tied to quality, researchers with the USC Schaeffer Center for Health Policy & Economics found. More seniors are choosing private Medicare Advantage plans over traditional Medicare, and continued overpayments could threaten the program’s long-term viability. The researchers suggested overhauling the current payment approach that links private plan rates to average spending by traditional Medicare beneficiaries. Another option would be to institute competitive bidding by Medicare Advantage plans to determine what insurers are paid. (Article here)