50 Wishes for
Medicare’s Future

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Wish #16:
Equalize payments between Original Medicare and Medicare Advantage (MA) plans

Prior to the Affordable Care Act (ACA), the federal government paid MA plans $14 billion more for care provided to MA enrollees than if the same care had been provided under Original Medicare—or about $1,000 more per enrollee. Through the ACA, these overpayments were gradually reduced. Still, more can be done to create a level playing field between Original Medicare and MA plans. Congress should eliminate remaining overpayments to MA plans and implement reforms to halt abuses of patient categorization rules —known as “upcoding”—that some health plans engage in to secure unacceptably high payments.