Advancing Medicare: Examining the Role of Private Plans

For decades, the role of private plans in Medicare has been a hotly debated issue. Over the next few years, it is likely to gain even greater prominence as policymakers respond to fiscal pressures created by the retirement of the baby boom generation. Researchers at the Urban Institute will analyze Medicare Advantage data to explore: 1) the determinants of Medicare Advantage plan costs, and the extent to which competition and plan structure account for cost differences across markets and types of plans; 2) how the Affordable Care Act’s increased emphasis on plan performance in setting plan payment rates (through the new five-star rating system) is affecting plans and markets; and 3) the potential impact that “premium support” proposals, which would increase the role of private plans, may have on Medicare program costs and beneficiary out-of-pocket costs.