Medicare Advantage: What are We Trying to Achieve Anyway
![handle is hein.journals/sljhlp1 and id is 417 raw text is: MEDICARE ADVANTAGE: WHAT ARE WE TRYING TO ACHIEVE
ANYWAY?*
TIMOTHY D. McBRIDE
By one summary measure, the Medicare Advantage (MA) plans created
by the Medicare Prescription Drug, Improvement, and Modernization Act
(MMA) of 2003' are a big success. Almost one in five Medicare
beneficiaries elected to enroll in private MA plans in 2007.2 Enrollment
grew almost 40% in just two years, from 4.9 million persons in 2005 to 8.1
million in 2007.3 The MA Program, under Part C of the Medicare Program,
is the latest reinvention of the original Medicare risk contract program,
which was established initially in the 1970s and altered in 1997 by the
legislation that created the Medicare+Choice (M+C) Program.4 The MA
Program provides an alternative for Medicare recipients, who can choose
between the traditional Medicare fee-for-service (FFS) program and an MA
plan.5
* Editor's Note: Dr. McBride spoke on this topic at the 2007 Saint Louis University Health Law
Symposium on Medicare After the Medicare Modernization Act. Other articles based on this
symposium were published in the inaugural issue of the Saint Louis University Journal of Health
Law & Policy.
Professor, Saint Louis University School of Public Health.
1. Medicare Prescription Drug, Improvement, and Modernization Act of 2003, Pub. L.
No. 108-173, 117 Stat. 2066 (codified in scattered sections of 42 U.S.C. & 26 U.S.C.).
2. CTRS. FOR MEDICARE & MEDICAID SERVS., MEDICARE ADVANTAGE IN 2007, at 8 (2007),
at www.cms.hhs.gov/MCRAdvPariDEnrolData/ (download Medicare Advantage 2007
Overview; then follow Medicare Advantage in 2007 icon) (last visited June 24, 2008)
[hereinafter CMS 2007]; see also THE HENRY J. KAISER FAMILY FOUND., MEDICARE ADVANTAGE
(MA) PLAN PENETRATION 2007, at www.statehealthfacts.org/comparetable.jsp?ind=329&
cat=6 (last visited June 24, 2008) (listing percent enrollment in Medicare Advantage plans in
each state as well as the national percent of Medicare Advantage enrollments).
3. MEDICARE PAYMENT ADVISORY COMM'N, A DATA BOOK: HEALTHCARE SPENDING AND THE
MEDICARE PROGRAM 153 (2007), available at www.medpac.gov/documents/Jun07DataBook-
Entire report.pdf (last visited June 23, 2008) [hereinafter MEDPAC, A DATA BOOK].
4. STAFF OF THE COMM. ON WAYS & MEANS, U.S. HOUSE OF REPRESENTATIVES,
BACKGROUND MATERIAL AND DATA ON PROGRAMS WITHIN THE JURISDICTION OF THE HOUSE
COMMITTEE ON WAYS AND MEANS, app. E, at E-2 (2004), available at hftp://waysand
means.house.gov/media/pdf/greenbook2003/AppendixE.pdf (last visited June 24, 2008)
[hereinafter GREEN BOOK].
5. Id.](ViewImageLocal?handle=hein.journals/sljhlp1&div=18&collection=journals&method=preview&ext=.png&size=3)
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Medicare Advantage: What are We Trying to Achieve Anyway
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