Medicare Advantage Organizations: Actual Expenses and Profits Compared to Projections For 2006
DIANE Publishing, 2010 - 14 pages
The fed. govt.'s spending on the Medicare Advantage (MA) program has grown substantially in recent years, from $60 billion in 2006 and $77 billion in 2007 to $91 billion in 2008. MA org. provide health care coverage to Medicare beneficiaries through private health plans, thus offering an alternative to the original Medicare fee-for-service program. Payments to MA org. are, in part, based on the projected expenditures org. submit in their bids for providing Medicare-covered services, as well as actual enrollment and beneficiary health status. In 2008, MA org. spent less on medical expenses and earned more profits than projected. MA org. actual profit margin was 5% of total revenue which was $1.1 billion more in 2005 than MA org. had projected.
What people are saying - Write a review
We haven't found any reviews in the usual places.
actual and projected actual medical expenses actual profit margin additional benefits aggregate medical expenses Amount in dollars andProfits as Amounts approximately $1.1 billion benchmark beneficiaries with additional benefits or cost-sharing Bid Pricing contains MA organizations contracts cost-sharing reductions difference between actual dollars billions earned more profits expenses and earned expenses and profits expenses in 2005 Fee-for-Service form was submitted greater than projected health benefit plan higher-than-projected HMOs June 2008 report less on medical Less Than Projections lower than projected MA organizations reported medical and non-medical Medical expensesa Medicare Advantage member months member per month non-medical expenses organization’s bid organizations reported organizations submitted out-of-network percent of total percentage of revenue PFFS plan types plan’s PPOs prevailing range projected aggregate medical projected expenses Projected Medical Expenses Projected Percentage projected profits projections for 2006 required to submit revenue Amount revenue on medical self-reported actual profit total revenue two-year look-back form