tci Medicare Compliance & Reimbursement - 2005 Issue 15

MEDICARE ADVANTAGE: Who Gets To Keep Medicare Savings: Health Plans Or The Government

Money still headed to MAs, says Prez.President Bush's fiscal year 2005 budget proposal would provide an additional $8.3 billion for Medicare Advantage private health plans from 2006 through 2010 by slowing the move to overall risk-adjusted payments.  Since MA plans enroll a slightly healthier-than-average population, Medicare eventually expects to pay MA plans less overall as reimbursement is more heavily adjusted to account for risk. After slowing the move to risk adjustment several times, policymakers had generally assumed that the government would retain savings reaped from risk-adjusting plan payments from 2006 onward. But in the fine...

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