Biden Leaving His Mark On Medicare Advantage
A very good article from Bridget Early in Modern Healthcare on the history of Medicare Advantage (MA) and how the Biden administration is leaving its mark on the program. I do take issue with the continual citing of what I think is a terribly biased overpayment figure (in this article $83 billion and I have seen even more ridiculous figures). But she has an extremely balanced approach and quotes both sides of the debate (some of the most qualified you can find) and reasonably speaks to the potential damage in the form of benefit reductions and geographic contraction that is occurring due to certain policies. It gives you a good feel for MA’s history and what is going on today.
The article does a good job at inventorying changes, including health equity, risk adjustment changes, supplemental benefit changes, marketing reform, and prior authorization restrictions. As you know, I do support some reforms in MA but feel CMS has been misguided recently on some changes they made to MA, which led to the benefit reductions and geographic contraction.
The article raises an interesting point on the careful balancing act regarding oversight of the industry. Despite some of my recent misgivings about regulatory policies, I have always and still do give credit to the Centers for Medicare and Medicaid Services (CMS) on being a good regulator, moving healthcare policy forward in a reasonable and accountable fashion.
(Article may require a subscription.)
#cms #medicareadvantage
https://www.modernhealthcare.com/politics-policy/joe-biden-medicare-advantage-cms-meena-seshamani
