tci Medicare Compliance & Reimbursement - 2004 Issue 17

Medicare Advantage: MedPAC: Medicare Private Plans Cost More Than FFS

Health plans, now eager to join Medicare, dispute the findings.Medicare pays private plans 7 percent more than it would cost to cover the same people through the program's fee-for-service arm, the Medicare Payment Advisory Commission reported April 8. Fifty-three percent of all Medicare beneficiaries and 45 percent of private-plan -- Medicare Advantage -- enrollees live in counties where 2004 payment rates for private plans will exceed FFS costs by at least 5 percent, said MedPAC. The Commission warned that its figures could even understate the payment differentials, since they assume, in contravention of most research, that private-plan...

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