Inexplicably and inexcusably, the Centers for Medicare and Medicaid Services has issued a notice that it plans to increase overpayments to Medicare Advantage plans by 7.98% in 2023, Modern Healthcare reports. As it is, MA plans spend $1,680 less per enrollee than traditional Medicare on medical services and are paid four percent more. If changes are to be made, MA payments should be cut, and CMS should invest more in traditional Medicare.
CMS currently intends to raise rates for Medicare Advantage plans just shy of 8 percent. CMS makes this proposal notwithstanding recent projections that it will overpay MA plans as much as $600 billion over the next eight years if it doesn’t reform its payment system for MA. And, it somehow believes that MA has the means to address health equity and social determinants of health, although data to support that belief is tenuous at best.
If permitted, the increase in payment to MA plans will be almost twice the increase of last year. For sure, this increase will go to additional benefits and marketing that lures healthy people into MA plans. But, you can be sure that it is all part of a big bait and switch in the foreseeable future when Congress cuts payments to MA plans to shore up the Medicare Trust Fund, and MA plans in turn shift substantial additional costs onto their enrollees.
CMS currently rewards plans with four- and five-star ratings. But, these ratings are a farce and do not speak to the quality of care people receive in their Medicare Advantage plans. MedPac has said year after year that it cannot assess quality. MA plans do not report complete and accurate data that would allow quality assessment.
CMS Administrator Chiquita Brooks-LaSure ignores health inequities that MA plans promote by rationing care based on the ability to pay. People with costly health conditions tend to disenroll from Medicare Advantage plans to traditional Medicare when they can, at disproportionately high rates. Traditional Medicare does not discriminate based on the ability to pay and is able to achieve health equity for anyone with supplemental coverage.
Comments on the notice are due March 4.
Here’s more from Just Care:
- Advice A to Z: Everything (almost) you need to know
- Avoid bad Medicare Advantage plans
- Medicare Advantage plans are a bad deal for taxpayers
- Four things to think about when choosing between traditional Medicare and Medicare Advantage plans
- MedPAC: Traditional Medicare consistently costs less than Medicare Advantage