Spending on Medicare Advantage Quality Bonus Program Payment Reached $10 Billion in 2022

(By Jeannie Fuglesten Biniek, Meredith Freed, Anthony Damico, and Tricia Neuman for Kaiser Family Foundation Published: Aug 25, 2022)

The Affordable Care Act (ACA) established a quality bonus program (QBP) that increased payments to Medicare Advantage plans based on a five-star rating system. The goal of the program is to encourage plans to compete for enrollees based on quality. In recent years, the Medicare Payment Advisory Commission (MedPAC) has raised concerns that the QBP includes too many measures, does not adequately account for social risk factors, and may not be a useful indicator of quality for beneficiaries because star ratings are reported at the contract rather than the plan level. Most Medicare Advantage contracts include multiple plans, which may have different benefits and serve different geographic areas. Given these concerns, MedPAC has recommended replacing the current approach with an alternative Medicare Advantage value incentive program (MA-VIP), which would include a small set of quality measures, evaluate plan quality at the local level, and stratify plans by enrollee characteristics when making comparisons, among other changes. Others have questioned whether the QBP may inadvertently exacerbate racial disparities, without leading to improvements in quality. Continue reading here…

Notice: The link provided above connects readers to the full content of the posted article. The URL (internet address) for this link is valid on the posted date; medicarereport.org cannot guarantee the duration of the link’s validity. Also, the opinions expressed in these postings are the viewpoints of the original source and are not explicitly endorsed by AMAC, Inc.; the AMAC Foundation, Inc.; or medicarereport.org