![]() The majority of Medicare Advantage enrollees (75%) are in plans that are receiving bonus payments in 2022.Federal spending on Medicare Advantage bonus payments has increased every year since 2015 and will reach at least $10 billion in 2022.Others have questioned whether the QBP may inadvertently exacerbate racial disparities, without leading to improvements in quality.Īs a backdrop to these policy discussion, this analysis examines trends in bonus payments to Medicare Advantage plans, enrollment in plans in bonus status, and how these measures vary across plan types and firms, using publicly available on Medicare Advantage enrollment, payment rates, and quality ratings. Given these concerns, MedPAC has recommended replacing the current approach with an alternative Medicare Advantage value incentive program (MA-VIP), which would include a small set of quality measures, evaluate plan quality at the local level, and stratify plans by enrollee characteristics when making comparisons, among other changes. Most Medicare Advantage contracts include multiple plans, which may have different benefits and serve different geographic areas. ![]() In recent years, the Medicare Payment Advisory Commission (MedPAC) has raised concerns that the QBP includes too many measures, does not adequately account for social risk factors, and may not be a useful indicator of quality for beneficiaries because star ratings are reported at the contract rather than the plan level. The goal of the program is to encourage plans to compete for enrollees based on quality. The Affordable Care Act (ACA) established a quality bonus program (QBP) that increased payments to Medicare Advantage plans based on a five-star rating system. ![]()
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