tci Medicare Compliance & Reimbursement - 2004 Issue 22

HEALTH PLANS: Another Report Says Plans Get More Than FFS

Medicare reform is steering the dollars towards managed care plans. According to a May 20 Commonwealth Fund report, Medicare private plans will receive per-enrollee payments in 2004 averaging 8.4 percent above fee-for-service cost. For each Medicare Advantage enrollee, the government will pay $552 more than it would were the same beneficiary in the FFS arm of the program, say researchers Brian Biles and Lauren Hersch Nicholas of George Washington University and Barbara Cooper of the Commonwealth Fund. All told, they conclude, the private plans will cost Medicare an additional $2.75 billion in 2004. "Some of that $2...

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