Title | Do Medicare Advantage Rebates Reduce Enrollees' Out-of-Pocket Spending? |
Publication Type | Journal Article |
Year of Publication | 2018 |
Authors | Nicholas, LHersch, Wu, S |
Journal | Medical Care Research & Review |
ISSN Number | 1552-6801 |
Keywords | Medicare linkage, Medicare/Medicaid/Health Insurance |
Abstract | The majority of Medicare Advantage (MA) plans receive payments that exceed their costs of providing basic Medicare benefits. There is controversy about whether these payments are passed on to the enrollees as supplemental benefits or are retained by plans. We used survey data on MA beneficiaries' actual out-of-pocket (OOP) spending linked to MA payment information to test whether higher plan payments and rebates lowered enrollee OOP spending. We used instrumental variables regression models to address concerns that plan payments and rebates may reflect anticipation of enrollees with particular health-spending profiles. We found that beneficiaries recovered only $0.65 of every $1.00 in payments exceeding fee-for-service spending through lower OOP spending but more than fully recovered the value of the rebates supporting supplemental benefits. |
DOI | 10.1177/1077558718807847 |
User Guide Notes | |
Alternate Journal | Med Care Res Rev |
Citation Key | 9963 |
PubMed ID | 30382801 |
PubMed Central ID | PMC6494723 |
Grant List | K01 AG041763 / AG / NIA NIH HHS / United States T32 HS000029 / HS / AHRQ HHS / United States |