GAO Report on Medicare Advantage Plan Design
The Government Accountability Office (GAO) has issued a report entitled "Medicare Advantage: Relationship between Benefit Package Designs and Plans' Average Beneficiary Health Status." GAO examined (1) MA plan benefit packages by average health status of plans’ enrolled beneficiaries, (2) distribution and characteristics of MA plans by average beneficiary health status, and (3) CMS’s process for ensuring that benefit packages do not discriminate with respect to health status. Among other things, the GAO found that plans in the good health group generally had lower premiums, higher cost sharing for certain services, and fewer additional benefits than plans in the poor health group in 2008. CMS has revised its process for reviewing MA plans for the likelihood of discrimination, and it developed a new methodology for setting cost-sharing thresholds. For contract year 2010, CMS contacted all MA plans with benefit packages likely to discriminate, and all plans subsequently met cost-sharing thresholds.
