Berenson Robert A
Urban Institute, Washington, DC, USA.
Health Aff (Millwood). 2004 Jul-Dec;Suppl Web Exclusives:W4-572-85. doi: 10.1377/hlthaff.w4.572.
The Medicare Prescription Drug, Improvement, and Modernization Act (MMA) raised payment levels for established Medicare Advantage (private) local plans and would-be regional preferred provider organizations (PPOs). Even though plans on average receive about 108 percent of what would have been spent for the same beneficiaries in traditional Medicare, the Centers for Medicare and Medicaid Services (CMS) added another 2.3 percent in 2004 and 4.0 percent in 2005 in its implementation of risk-adjusted payments. Although MMA gives a clear preference to private plans to start a fundamental restructuring of Medicare, the question remains whether Congress will maintain overpayments to private plans when faced with the pressure to reduce budget deficits.
《医疗保险处方药、改进与现代化法案》（MMA）提高了现有医疗保险优势（私人）地方计划以及潜在的区域优先提供者组织（PPO）的支付水平。尽管这些计划平均获得的资金约为传统医疗保险中相同受益人群原本支出的108%，但医疗保险和医疗补助服务中心（CMS）在2004年又额外增加了2.3%，并在2005年实施风险调整支付时增加了4.0%。尽管MMA明确倾向于私人计划以启动医疗保险的根本性重组，但问题仍然存在，即国会在面临削减预算赤字的压力时，是否会继续对私人计划支付过高费用。
