Benefits of Medicare Advantage plans may be overhyped, according to Kaiser Family Foundation study results that showed that participants flipping to private plans were already using fewer services.
Seniors enrolled in MA cost the government, on average, $1,250 less in the year before they switched to a private plan, compared to those who remained in traditional Medicare and used fewer services. This indicates that the Centers for Medicare & Medicaid Services could be overpaying advantage plans by billions of dollars, report authors said.
“If higher-cost nursing home residents are remaining in traditional Medicare while lower-cost residents are moving to Medicare Advantage plans, it could make it easier for Medicare Advantage plans serving the nursing home population to be profitable, which may explain the relatively recent increase in firms offering Special Needs Plans for this population,” KFF noted.
“It could add up to a substantial amount of money,” said Gretchen Jacobson, associate director of Kaiser’s Program on Medicare Policy and report co-author, to CNN.
The analysis compared beneficiaries who switched to an MA plan in 2016 to those on traditional Medicare. For those living in nursing homes who moved to MA plans, the government averaged $1,825 less per person per year than on residents who stayed.
From the June 6, 2019 Issue of McKnight's Long-Term Care News
