Traditional Medicare is losing enrollees and political support to a programmatic frenemy: the private health plans that cover a third of Medicare participants.
These Medicare Advantage plans receive a fixed amount per enrollee to provide benefits rather than a per-service payment rate. That means the plans have more incentive than physicians in traditional Medicare to provide efficient, cost-saving treatment. But longstanding cost and quality questions about Medicare Advantage plans raise concerns about federal efforts to expand their role in a restructured Medicare program focused on value-based medicine.
“We’re lacking a lot of information about the experience of beneficiaries in Medicare ...