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01-02-2020

Contract Consolidation in Medicare Advantage: 2006–2016

Authors: David J. Meyers, MPH, Momotazur Rahman, PhD, Ira B. Wilson, MD, MS, FACP, Vincent Mor, PhD, Amal N. Trivedi, MD, MPH

Published in: Journal of General Internal Medicine | Issue 2/2020

Excerpt

Over 33% of Medicare beneficiaries are enrolled in Medicare Advantage (MA).¹ The MA Quality Improvement Program (QIP), which the Centers for Medicare and Medicaid Services (CMS) launched as a demonstration in 2012 and made permanent in 2014, rates all MA contracts from 2 to 5 stars based on quality measures. CMS rewards contracts rated 4+ stars with 5% per capita bonus payments and has paid over $3.1 billion in bonuses annually. …

Neuman P, Jacobson GA. Medicare advantage checkup. N Engl J Med. 2018;0(0):null. https://doi.org/10.1056/NEJMhpr1804089.CrossRef

Mathews AW, Weaver C. Insurers game medicare system to boost federal bonus payments. Wall Street J. https://www.wsj.com/articles/insurers-game-medicare-system-to-boost-federal-bonus-payments-1520788658. Published March 11, 2018. Accessed July 10, 2018.

Medicare Payment Advisory Commission. Report to the Congress: Medicare Payment Policy; 2018.

Center for Medicare and Medicaid Services. Announcement of Calendar Year (CY) 2019 Medicare Advantage Capitation Rates and Medicare Advantage and Part D Payment Policies and Final Call Letter. April 2018. https://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/Downloads/Announcement2019.pdf. Accessed April 2, 2018.

Reid RO, Deb P, Howell BL, Conway PH, Shrank WH. The roles of cost and quality information in medicare advantage plan enrollment decisions: an observational study. J Gen Intern Med. 2016;31(2):234–241. https://doi.org/10.1007/s11606-015-3467-3.CrossRefPubMed

Title: Contract Consolidation in Medicare Advantage: 2006–2016
Authors: David J. Meyers, MPH
Momotazur Rahman, PhD
Ira B. Wilson, MD, MS, FACP
Vincent Mor, PhD
Amal N. Trivedi, MD, MPH
Publication date: 01-02-2020
Publisher: Springer US
Published in: Journal of General Internal Medicine / Issue 2/2020
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI: https://doi.org/10.1007/s11606-019-05036-0

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