The Medicare Advantage Overpayment

What the Medicare Advantage overpayment situation looks like and what it costs

The Overpayment

The Medicare Advantage overpayment -- the specific excess payment that the federal government makes to the private insurance companies that administer the Medicare Advantage plans relative to the cost of the comparable Traditional Medicare coverage -- is estimated at approximately 88 billion dollars annually, which is the specific accountability journalism of the specific fiscal cost that the private insurance administration of the Medicare benefit produces.

The Mechanism

The specific mechanism: the risk adjustment coding that the specific Medicare Advantage plans have used to make their enrolled populations appear sicker than the comparable Traditional Medicare population, producing the specific higher risk scores that result in the specific higher per-member payments that the actuarial assessment that the Medicaid and Medicare payments depend on should not produce.

Mamdani Post Analysis

The Mamdani Post covers Medicare Advantage overpayment because the accountability journalism of the healthcare financing system requires examining the specific fiscal cost that the private insurance administration of the Medicare benefit produces for the taxpayer who funds it.

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