Friday, December 05, 2014: Medicare Advantage in a Changing Health System

Medicare Advantage in a Changing Health System

Friday, December 05, 2014
Almost three in ten Medicare beneficiaries are enrolled in the Medicare Advantage (MA) program, which offers a choice of competing private health plans – typically managed care plans such as HMOs and PPOs. The Affordable Care Act (ACA) made significant changes to the way Medicare Advantage plans are paid, including tying a portion of payments to a quality star rating system. Despite predictions that MA enrollment would drop in the wake of scheduled payment reductions to the program, the percentage of seniors who are choosing to enroll in MA plans is still growing. However, the impact of upcoming reductions remains the subject of much debate.

How is the Medicare Advantage program structured? How is it financed? What are other important provisions for quality of care, risk adjustment, network adequacy, and beneficiary protections? What changes did the ACA and subsequent federal law make to Medicare Advantage? What is the outlook for competition, quality, and affordability? What are the current policy debates surrounding the MA program?

A distinguished panel of experts addressed these and related questions:

Arielle Mir, assistant director, Medicare Payment Advisory Commission (MedPAC), provided an overview of the MA program, including the basics of financing, the quality rating system, risk adjustment, and recent policy changes.

Mark Miller, executive director, Medicare Payment Advisory Commission (MedPAC), discussed current policy debates and MedPAC considerations regarding MA, incorporating current statistics such as enrollment, plan participation and premiums.

Marsha Gold, senior fellow emeritus, Mathematica Policy Research, presented a summary of research on the quality of MA plans.

Bob Margolis, CEO emeritus, HealthCare Partners, provided the perspective of a provider group that has implemented delivery system reforms to provide better integrated, coordinated care.

Ed Howard of the Alliance for Health Reform moderated.

Follow the briefing on Twitter: #MedicareAdvantage

Contact: Sarah Dash [email protected] (202)789-2300

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