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Capitol Health Call
April 9, 2008

Medicare (Dis)Advantage?

JAMA. 2008;299(14):1657. doi:10.1001/jama.299.14.1657-c

Medicare Advantage, managed-care plans offered by private insurers that advocates have touted as a potential way to reduce out-of-pocket health care costs for enrollees, is not working as intended, a Government Accountability Office (GAO) report found.

The report, released February 28, compared spending by Medicare Advantage plans (which covered about 8 million people and received about $59 billion from the federal government in 2006) and traditional Medicare fee-for-service plans. Medicare Advantage plans receive a per-member, per-month payment to provide services covered under Medicare fee-for-service plans. The Advantage plans also receive additional Medicare payments that are supposed to fund benefits not covered under the fee-for-service plans, to lower premiums, or to reduce beneficiary cost sharing.

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