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CMS PAYMENTS TO INSURANCE PLANS
By Eric Bricker MD
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CITE: https://www.r2library.com/Resource
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Filed under: "Doctors Only", Accounting, Career Development, Drugs and Pharma, Ethics, Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Insurance Matters, Risk Management | Tagged: CMS, Eric Bricker MD, ICD-10, medicare, Medicare Advantage Plans, medicare claims, Medicare Risk Adjustments, traditional medicare |
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Whether the government is saving money with Advantage remains doubtful. Under Advantage, the government pays insurance companies a fixed amount per member based in part on each individual’s health status; under traditional Medicare, the government pays medical providers on a fee-for-service basis.
The set payments in Advantage are supposed to serve as an incentive to avoid costly, unnecessary care and offer services that might not fit the Medicare billing system.
Cliff
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