Biles Brian, Adrion Emily, Guterman Stuart
Department of Health Policy, School of Public Health and Health Services, The George Washington University, USA.
Issue Brief (Commonw Fund). 2008 Sep;43:1-15.
The Medicare Modernization Act of 2003 explicitly increased Medicare payments to private Medicare Advantage (MA) plans. As a result, every MA plan in the nation is paid more for its enrollees than they would have been expected to cost in traditional fee-for-service Medicare. The authors calculate that payments to MA plans in 2008 will be 12.4 percent greater than the corresponding costs in traditional Medicare-an average increase of $986 per MA plan enrollee, for a total of more than $8.5 billion. Over the five-year period 2004-2008, extra payments to MA plans are estimated to have totaled nearly $33 billion. Although Congress recently enacted modest reductions in MA plan payments, these changes will not take effect until 2010. Moreover, while the new legislation removes a few factors contributing to the extra payments, a number of other factors remain unaffected.
2003年的《医疗保险现代化法案》明确提高了医疗保险对私人医疗保险优势(MA)计划的支付额度。结果,全国每个MA计划从其参保人那里获得的支付都比传统按服务收费的医疗保险预计花费的要多。作者计算得出,2008年对MA计划的支付将比传统医疗保险中的相应成本高出12.4%——每个MA计划参保人的平均增加额为986美元,总计超过85亿美元。在2004年至2008年的五年期间,对MA计划的额外支付估计总计近330亿美元。尽管国会最近适度削减了对MA计划的支付,但这些变化要到2010年才会生效。此外,虽然新立法消除了一些导致额外支付的因素,但其他一些因素仍未受到影响。