BY ALLYSON Y. SCHWARTZ, OPINION CONTRIBUTOR — THE HILL 03/31/21

there are still outlier critics. Some say Medicare Advantage is “too good,” making it hard for Traditional Medicare to compete. Others argue it is unfair that Medicare Advantage can offer extra benefits and lower cost to consumers. Add to this the looming financial challenge of the Medicare Trust Fund and there is more pressure to find savings in Medicare.

Health plans in Medicare Advantage are also required to identify all diagnoses each year for each enrollee, since payments are tied to risk of beneficiaries. [MA] Health plans tend to identify more diagnoses as compared to Traditional Medicare since Traditional Medicare is paid by the services provided for a particular episode of care. There is no annual reporting of all diagnoses in Traditional Medicare, so a difference between the two programs is to be expected

All the while, Medicare Advantage beneficiaries report an average annual savings of roughly $1,600 over their Traditional Medicare counterparts, as well as lower rates of avoidable hospitalizations and higher rates of preventive care and screenings.

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