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Alliance for Health Reform/Kaiser Family Foundation Washington, DC July 16, 2007 Medicare Advantage: Restructure Payments for Results Joseph Antos, Ph.D.

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Presentation on theme: "Alliance for Health Reform/Kaiser Family Foundation Washington, DC July 16, 2007 Medicare Advantage: Restructure Payments for Results Joseph Antos, Ph.D."— Presentation transcript:

1 Alliance for Health Reform/Kaiser Family Foundation Washington, DC July 16, 2007 Medicare Advantage: Restructure Payments for Results Joseph Antos, Ph.D. Wilson H. Taylor Scholar in Health Care and Retirement Policy American Enterprise Institute

2 2 Key MA payment principles Capitation Risk adjustment Competitive bidding

3 3 Why is there a problem? Aftermath of BBA97 Regional politics Flawed bidding system Incomplete competition

4 4 Current rhetoric focuses on “pay-fors” Willie Sutton was right— Go where the money is!

5 5 Broader policy objectives Better value—from FFS and MA Innovation in health care delivery More sensible benefit structures Fiscal restraint Options for consumers

6 6 Treat the cause, not the symptoms Take a lesson from Part D  Plans bid against each other, not against benchmarks Transition to full competition  Remember “comparative cost adjustment”?  FFS and MA should be on an equal footing on all dimensions, not only payment  Hold FFS and MA accountable for improving care delivery  Requires major FFS reform

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