![]() In the 8 years following the ACA, there was no differential change in MA enrollment between counties with larger vs smaller benchmark cuts (difference-in-differences estimate, 0.02 percentage points P = .98). Counties with benchmark cuts above the 75th percentile had population-weighted average benchmark cuts of 14.9% compared with 4.4% in other counties. Results Among 3138 counties with 37 639 county-year observations, ACA-induced benchmark cuts were sizeable and varied, ranging from 0% to 42.9% (mean, 5.9% ). A secondary analysis examined MA plan payments per member per month. Main Outcomes and Measures The primary outcome was the MA enrollment rate, defined as the proportion of a county’s Medicare beneficiaries enrolled in MA. Using 2008 to 2019 county-level enrollment and payment data, a difference-in-differences analysis was conducted comparing MA enrollment changes between counties with larger vs smaller benchmark reductions, before vs after the ACA. Objective To quantify the association between MA payment reductions under the Affordable Care Act (ACA) and MA enrollment growth.ĭesign, Setting, and Participants This retrospective cohort study examined the MA market before and after the ACA, which mandated cuts to MA benchmark payment rates. However, it is unclear whether payment reductions would compromise beneficiary access to the MA program. Importance Various policy proposals would reduce federal payments to Medicare Advantage (MA) plans. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment. ![]() Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography. ![]()
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