Date: 6/16/24
Name of podcast: Dr. Patient
Episode title and number: 24 The Disadvantage of Medicare Advantage, Part 1

Episode summary:
Wow, I knew Medicare was complicated but didn't realize just how complicated. I've spent the last few weeks diving deep and was most curious about Medicare Advantage, Part C of Medicare, where beneficiaries can sign up for private health insurance. This week I'll be talking about how bad this is for our federal budget, and how the model simply doesn't work fiscally. Next week, in Part 2, I'll be talking with Al (Alexandra) Eidenberg about why it's also bad for the beneficiaries themselves.

Guest(s): none

Key Terms:
CMS - Center for Medicare and Medicaid Services
HMO - Healthcare Maintenance Organization
Beneficiary or Enrollee - the person signing up for a health plan
Fee-for-service - a model of healthcare where a doctor or hospital gives a service and is then paid for it
Capitation - a monthly payment Advantage plans get per patient that are signed up on their plan

References:
Video by Congresspeople Mark Pocan, Jan Schakowsky and Ro Khanna
Center for Medicare and Medicaid Services
How the Government Updates Payment Rates for Medicare Advantage Plans
Understanding Medicare Advantage Payment
Medicare Advantage Risk Adjustment
US Sues Cigna for fraudulent diagnostic codes
Advantage plans overpaid by about $140 billion over last 12 years
Video: How to Sign up for Medicare
MedicareFAQ: Why Advantage Plans are Bad
Understanding Medicare Advantage Payment

Other podcasts on this topic:
Arm and A Leg
The Real Investment Show