The Medicare Advantage program, established last year, faces an uphill battle in its effort to restructure and privatize coverage for seniors, according to two studies published on the Health Affairs Web site. One report questioned whether Congress, facing a growing budget deficit, would be forced next year to reduce "sizable overpayments" earmarked under the Medicare Modernization Act for private insurers participating in the program. The report also speculated that proposed methods for opening Medicare Advantage to competitive bidding in the future would be unlikely to create the market forces needed to reduce prices and improve benefits.
The second report found that much like the Medicare+Choice program that preceded it, Medicare Advantage faces several challenges, including making a complex program understandable to beneficiaries; addressing plans' efforts to avoid enrolling sicker, high-cost beneficiaries; ensuring stability of benefits, providers and plan options; providing equal benefits across the country, including in rural areas; and controlling overall costs. Read the reports on healthaffairs.org. -- by Laura B. Benko