Skip to content
  1. Latest News

Fierce Healthcare: MedPAC supports changes to the development of MA plan payment benchmarks

The Medicare Payment Advisory Commission (MedPAC), which develops recommendations to Congress on Medicare policy, recently discussed the issue of how Medicare Advantage (MA) plans are paid and showed support to bring payments more in line with traditional Medicare fee-for-service. Amol Navathe is also part of the group, which largely favored creating a new payment approach that calculates MA payments based on a blend of local and national spending as opposed to the current methodology, which sets benchmarks on a county-by-county basis. The panel did not decide on how exactly to blend the Medicare benchmarks and has yet to formalize a recommendation to Congress. The meeting underscored the panel’s desire to make reforms to the MA payment structure. MedPAC data show that MA plan payments are on average 2% higher than traditional Medicare. Some members questioned about how aggressive any recommendation for new benchmarks should be. Some suggested that the commission be more aggressive in its recommendation to Congress in order to get the changes needed to overhaul the program. Karen DeSalvo, chief health officer at Google Health, cautions that while there is a need to be aggressive in savings, “we need to be balancing that with quality as we understand more about the quality of [MA] and how to compare that to fee-for-service.” Read more at Fierce Healthcare.

Research Areas