Medicare Advantage Reforms: Comparing House and Senate Bills

December 21, 2009 | Volume 74

Authors: Brian Biles, M.D., Ph.D., and Grace Arnold

Contact: Brian Biles, M.D., M.P.H., Department of Health Policy, School of Public Health and Health Services, The George Washington University, bbiles@gwu.edu
Editor: Steven J. Marcus

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Overview

The Medicare Advantage (MA) program, which enables Medicare beneficiaries to enjoy private health plan coverage, is a major element of the current health care reform discussion on Capitol Hill—in large part because payments to MA plans in 2009 are expected to run at least $11 billion more than traditional Medicare would have cost. While the pending Senate and House bills both endeavor to reduce these extra MA payments, their approaches are different. The bills also differ on other aspects of reforming the MA program, such as plans' allowable geographic areas, their risk-adjustment systems and reporting requirements, their potential bonuses for achieving high-quality care and providing good management, and their beneficiary protections. This issue brief compares the above and other provisions in the House and Senate bills, which have a common overall goal to improve the value that Medicare obtains for the dollars it spends.

Citation

B. Biles and G. Arnold, Medicare Advantage Reforms: Comparing House and Senate Bills, The Commonwealth Fund, December 2009.