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Time to Release Medicare Advantage Claims Data

机译:时间释放Medicare Advants声明数据

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摘要

Medicare Advantage plans represent a sizable and growing segment of the Medicare program as well as important private plan alternatives to traditional Medicare. According to the latest statistics, enrollment in Medicare Advantage plans increased from 13% of the Medicare population, or 5.3 million individuals, in 2004 to almost 33%, or 19 million individuals, in 2017, and government payments to Medicare Advantage plans have increased from $77 billion to more than $200 billion per year over the same period. With these payments, Medicare Advantage plans are obligated to provide at least the same level of coverage as traditional Medicare. However, Medicare Advantage plans have significant flexibility to augment benefits, and many plans both add benefits (eg, vision and dental coverage) and lower cost sharing; these enhancements have proven to be popular to many beneficiaries. These additional benefits can also come with certain restrictions not present in traditional Medicare, such as more limited networks of clinicians or health care organizations and more referral requirements to see specialists.
机译:Medicare Advantage计划代表Medicare计划的相当大,越来越多的细分市场以及传统医疗保险的重要私人计划替代品。根据最新统计数据,医疗保险优势计划的入学人数从医疗保险人口的13%增加,或者在2004年的530万人,2017年的近33%,或1900万个人,以及对Medicare Advantage计划的政府支付增加同期每年770亿美元超过2000亿美元。通过这些付款,Medicare Advantage计划有义务提供至少与传统Medicare的覆盖率相同。然而,Medicare Advantage计划具有显着的灵活性来增强福利,并且许多计划增加福利(例如,视觉和牙科覆盖率)和更低的成本分担;这些增强已被证明是对许多受益者欢迎。传统医疗保险中的某些限制也可能存在这些额外的福利,例如更多有限的临床医生或医疗组织网络以及更多的推荐要求来看专家。

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