Medicare Advantage is simultaneously *more* costly to the public, yet its enrollees receive *less* care.
Medicare Advantage plans employ two strategies to drive up overpayments from the government:
(1) Diagnostic upcoding (making patients "look" more sick on paper, which determines payments.)
(2) Avoiding truly sicker (read: unprofitable) enrollees.
These strategies generated more than half a *trillion* dollars in overpayments for MA plans between 2007 and 2024, according to one analysis from the nonpartisan Medicare Payment Advisory Commission.
Despite these overpayments, MA enrollees actually receive *less* care on average than those in traditional Medicare - by 9%.
How? Through managed care techniques like prior authorizations, network restrictions, and provider incentives to curtail care.
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