By NextBestFitMedicare Part C (Medicare Advantage)
endsEnd of Year 1Federal programs
Today
About 54% of Medicare enrollees in private plans paid by capitation, with networks, prior authorization, and supplemental benefits.
Under the plan
Ends after a final contract year (Year 1). Provider-run integrated care organizations may take capitated budgets without an insurance layer.
Trade-off
Ends coding-intensity overpayments (MedPAC: ~20% above FFS), but about 33 million people lose plans that score high on satisfaction.
Money
- Insurer & plan overhead eliminated$306.0B → $26.4B