Growth of Private Medicare Plans Clouded by Payment Questions

A fast-approaching enrollment tipping point for Medicare managed care plans is increasing the urgency for Congress and the HHS to resolve payment issues that threaten the viability and cost-effectiveness of the popular coverage option.

Medicare Advantage plans were paid $350 billion in taxpayer funding in 2021, and now cover nearly 46%, or more than 29.7 million, of Medicare’s 64.6 million beneficiaries. MA plan enrollment is expected to hit 31.8 million next year. In the near future, a majority of Medicare beneficiaries are expected to receive their benefits through MA plans, rather than through traditional fee-for-service Medicare.

That coverage ...