Medicare (Dis)Advantage?
Since this article does not have an abstract, we have provided the first 150 words of the full text.
- KEYWORDS:
- MANAGED CARE PROGRAMS
- MEDICARE
Medicare Advantage, managed-care plans offered by private insurers that advocates have touted as a potential way to reduce out-of-pocket health care costs for enrollees, is not working as intended, a Government Accountability Office (GAO) report found.
The report, released February 28, compared spending by Medicare Advantage plans (which covered about 8 million people and received about $59 billion from the federal government in 2006) and traditional Medicare fee-for-service plans. Medicare Advantage plans receive a per-member, per-month payment to provide services covered under Medicare fee-for-service plans. The Advantage plans also receive additional Medicare payments that are supposed to fund benefits not covered under the fee-for-service plans, to lower premiums, or to reduce beneficiary cost sharing.
The GAO said that while Advantage plans were paid, on average, 13% more in 2007 than the cost of care found in fee-for-service Medicare, 19% of Advantage beneficiaries were in plans that were projected to have …
