GAO: Most Medicare advantage plans meet medical expense standard

The federal health law requires the plans to pay out at least 85 percent of their premium dollars on medical expenses, or refund the excess revenue to the government.

Modern Healthcare: Medicare Advantage Plans Spent 86.3% Of Revenue On Medical Expenses In 2011: GAO Report
A new report from the Government Accountability Office suggests that most Medicare Advantage carriers won't struggle to meet the 85% medical-loss ratio imposed on the private Medicare plans starting in 2014 under the Patient Protection and Affordable Care Act. If plans fail to spend enough money on medical costs, they'll be required to refund excess revenue to the federal government (Demko, 1/23).

And in other Medicare news, a look at why the government's announcement that it would release physician payment data is getting criticism -

ProPublica: Some Predictions On How Medicare Will Release Physician Payment Data
The federal government's announcement last week that it would begin releasing data on physician payments in the Medicare program seems to have ticked off both supporters and opponents of broader transparency in medicine. For their part, doctor groups are worried that the information to be released by the Centers for Medicare and Medicaid Services will lack context the public needs to understand it (Ornstein, 1/23)..


http://www.kaiserhealthnews.orgThis article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

 

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