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Originally Posted by dpmers
Traditional Medicare only pays 80% hence most of the 22% difference in payments for MA vs Traditional Medicare
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You’re missing the point entirely. The government doesn’t care how much private insurance companies pay, they care about how much they pay out of the rapidly dwindling Medicare fund. Medicare Advantage plans were created in an attempt to team up with private insurance companies, as an alternative to traditional Medicare, in an effort to save costs and help shore up the Medicare financial situation. So far, the experiment has failed miserably. Despite the aggregate population of traditional Medicare subscribers being sicker than the Medicare Advantage population, it is estimated that Medicare pays 22% more for Medicare Advantage enrollees than it would have spent if those beneficiaries were enrolled in traditional Medicare. That’s an amount that translates into $83 billion for 2024 alone. And if you don’t want to believe me, look it up. It was reported to congress by MedPac, a nonpartisan and independent legislative branch charged with providing the US congress with analysis and policy advice on the Medicare program. The bottom line here is that something has to give with the whole Medicare Advantage program, it’s not working as intended.