Should Medicare Advantage Plans Receive Billions in Additional Risk-based Payments for Potentially Unmanaged Conditions?

Abstract

Medicare Advantage (MA) (ie, Medicare Part C), a private alternative to traditional fee-for-service Medicare, was first implemented in 19851 but has seen its most significant growth in the past 15 years. Although MA accounted for 36% of Medicare enrollment in 2020, research examining this program has been limited historically by the low quality of MA encounter data and its lack of availability (until recently) to researchers.