The Commonwealth Fund’s report comes amidst a groundbreaking study from Physicians for a National Health Program. Health policy experts at PNHP found that since 1985, MA plans have been overpaid $282.6 billion through selective enrollment processes, duplicate payments and excessive bonus payments.
Brian Biles, MD, a health policy professor at The George Washington University, led the Commonwealth Fund’s study, which delved into how the Patient Protection and Affordable Care Act will reduce the costs and improve care of MA beneficiaries. He and others found that in 2009, payments to MA plans exceeded projected spending by an average of 14.2 percent, resulting in $12.7 billion in excess payments.
The authors said the PPACA enacts three major changes to rein in those overpayments and achieve cost savings: rewards for the highest-quality MA plans, new benchmark rates and reduced rebates to MA plans.
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