Favorable Selection In MA Linked To Billions In Overpayments
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Wednesday, September 6, 2023 | The Latest Research, Commentary, And News From Health Affairs
Dear John,

We are excited to publish the first episode of our new health equity podcast, Research and Justice For All. The first season is sponsored by CVS Health, and you can read more details about the series below.
Favorable Selection In MA Linked To Billions In Overpayments
In their article in the September issue of Health Affairs, Andrew Ryan and his team of coauthors examine the relationships among unobserved favorable selection, benchmark setting in Medicare Advantage (MA), and payments to plans in MA.

They find that "favorable selection into MA led to underpayments for counties with lower MA penetration and overpayments to counties with higher MA penetration."

At the same time, MA enrollment has shifted to countries with higher MA penetration, ultimately leading to overpayments to MA plans averaging $9.3 billion per year between 2017 and 2020.

Ryan and coauthors conclude that benchmark-setting reforms could "mitigate the impact of favorable selection in MA" and avoid overpayment.
 
Introducing: Research and Justice For All

Research and Justice For All is a podcast from Health Affairs that provides perspectives on how to dismantle unjust systems and structures that have long impacted health outcomes in historically marginalized populations.

Hear how to challenge injustices in health care – rooted in racism, sexism, ableism, and other forms of exclusion – through research, evidence, community-building, and innovative solutions.

The first season, "Private Sector Solutions for Health Equity," is sponsored by CVS Health and cohosted by Sree Chaguturu, Chief Medical Officer (CVS Health) and Joneigh Khaldun, Chief Health Equity Officer (CVS Health).

In the first episode of Research and Justice For All, Chaguturu and Khaldun interview Thomas Sequist from Massachusetts General Brigham on the important role of health and hospital systems in driving health equity in the US.
 

Health Affairs' Rob Lott and Chris Fleming discuss the Biden administration's announcement regarding the first 10 drugs selected for Medicare price negotiation.
 
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