Medicare Advantage Payment Provisions, by Brian Biles and Grace Arnold. This appears to be a must-read piece for anyone wishing to understand the implications of the ACA for MA.
The Health Care and Education Affordability Reconciliation Act of 2010 makes major changes to Medicare Advantage (MA) payment policies. Overall, payments to MA plans will be reduced from the current national average of 113 percent of local fee‐for‐service (FFS) costs to a new average of 101 percent of FFS costs. The Congressional Budget Office (CBO) has estimated that the new polices will reduce Medicare spending by $132 billion over 10 years. The new policies will set county payment benchmarks for MA plans at 115 percent, 107.5 percent, 100 percent, and 95 percent of local FFS costs depending of the relative level of FFS costs in the county. The MA plan rebate policy will be reduced from the current level of 75 percent. A new program of plan performance‐based payments will be available to certain plans and will increase benchmarks and rebates to plans with high performance scores. This issue brief presents analysis, sing data from 2009, of the impact of these new policies on payments o private plans across the nation.
National Institute for Health Care Management’s Expert Voices Series. There are many excellent brief papers by top scholars.
Weighing The Impact Of Health Reform. Another entire Health Affairs issue on health reform.