Former CMS chief says Medicare Advantage plans are draining the program

Medicare is in trouble, and it’s largely the fault of the Medicare Advantage program run by private insurers, said Donald Berwick, who led Medicare during the Obama administration.

More than half of people on Medicare have a private Medicare Advantage plan, and MA’s market share is growing rapidly.

Medicare pays Medicare Advantage plans a fixed annual rate for each enrollee. This arrangement should encourage insurers to do what is necessary to keep enrollees healthy, rather than just offering services that Medicare covers. But the complicated system for calculating MA wages, which encourages heavy coding to make patients look really sick on paper, results in taxpayers paying more than $80 billion more annually for people in Medicare Advantage than those in traditional Medicare .