MedPAC Chair Defends MA Analysis
Dr. Amol Navathe, the new chair of congressional Medicare policy arm MedPAC, defended the work and Medicare Advantage over-reimbursement estimates of his organization. He doubled down on MedPAC’s view that MA is reimbursed 14% more than what is spent in traditional fee-for-service (FFS). Critics of MedPAC, including me, stand by our assessment that MedPAC is relying on old data that does not recognize risk adjustment reforms and updates. In addition, MedPAC has picked up some spurious academic analyses on so-called favorable selection and has essentially adopted them as fact. The chairman himself is an academic and his defense of this process is expected.
Republicans in Congress are challenging MedPAC’s way of thinking, considering a bill to force MedPAC to broaden its viewpoints, including definitively setting aside the favorable selection argument. As MedPAC always does, it says it will open the doors and encourage engagement, but its studies seem to be closed to alternative ways of thinking. When it is found to be errant, it seems to obfuscate that fact with more of the same research. Indeed, the Centers for Medicaid and Medicaid Services (CMS) seems convinced the 14% number is absolutely inflated. Numerous other reports seem to conclude that as well, arguing MedPAC simply does not understand the difference between managed care and a 60-year-old FFS system.
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