Wednesday, March 22, 2023 | The Latest Research, Commentary, And News From Health Affairs
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Ahead Of Print
There have been calls to reduce Medicare Advantage (MA) benchmarks in response to concerns that MA plans are overpaid.
Benchmarks are the maximum payments set by the Centers for Medicare and Medicaid Services that MA plans bid against to set premiums and fund extra benefits.
A new study released ahead of print by Health Affairs seeks to answer a question lost in the current debate: What specific benefits would be lost if MA payment rates were reduced?
Michael Chernew and coauthors use variation in benchmark changes across markets from 2012 to 2019 to assess the relationship between Medicare Advantage benchmarks, plan generosity, and benefits.
According to the authors' analysis, a
decrease of $1,000 per year in benchmarks would result in a $60 per year premium increase per beneficiary, small copay increases, and increases of about $27 in annual deductibles
Further, Chernew and coauthors estimate that higher benchmarks also would lead to reductions in cost sharing.
"Overall, these results generally suggest only modest effects of reductions in MA benchmarks on benefit availability," they conclude.
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