MedPAC Again Lambasts Medicare Advantage Overpayments; AHIP Fires Back
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Apr 03, 2025
The Medicare Payment Advisory Commission’s (MedPAC) scrutiny of Medicare Advantage’s financial status continued in its March 2025 Report to the Congress: Medicare Payment Policy. The commission estimated that in 2025, the government will pay $84 billion more than it would pay if MA members were instead enrolled in fee-for-service (FFS) Medicare. These so-called overpayments are driven by MA plans’ enrollment of a healthier risk pool — or favorable selection — MedPAC observed, echoing its previous status reports on MA. The industry’s largest trade group, however, maintained that MedPAC’s MA cost analyses are based on incomplete data and faulty assumptions.
“Many comparisons of MA to FFS spending are conducted on an invalid ‘apples-to-oranges’ basis,” a spokesperson for America’s Health Insurance Plans (AHIP) tells AIS Health, a division of MMIT. “Research has shown that ‘apples-to-apples’ FFS costs more than government estimates, which suggests MA delivers savings to the Medicare program,” the spokesperson adds, citing four recent studies on the topic.
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