Medicare Advantage Delivers Better Care And Saves Money: A Response To Gilfillan And Berwick
George C. Halvorson HealthAffairs 1/7/2022
A Health Affairs Forefront article by Richard Gilfillan and Donald Berwick, published in two parts on September 29 and 30, offered a severe critique of the Medicare Advantage (MA) program that is flawed in important ways that need to be addressed. Below, I point out some of those flaws and explain why MA, and the capitation system it employs, represent our best hope for health reform and high-quality, cost-effective care. I conclude by briefly suggesting a path forward.
MA has now enrolled slightly more than 40 percent of the people with Medicare coverage in our country. That number will continue to grow because the actual MA program is very different in key ways from the imagined program that Gilfillan and Berwick criticize and obviously dislike. The authors clearly do not understand the business model or the functionality of MA; they focus instead on cash flow and data flow issues, and they get some of these significantly wrong.
