Bill Overview
Title: Medicare Advantage Quality Payment Relief Act of 2022
Description: Medicare Advantage Quality Payment Relief Act of This bill requires the Centers for Medicare & Medicaid Services to disregard the application of certain percentage quality increases when calculating the maximum payment that may be made to a Medicare Advantage organization.
Sponsors: Sen. Daines, Steve [R-MT]
Target Audience
Population: Medicare Advantage plan enrollees
Estimated Size: 31000000
- Medicare Advantage (MA) plans are a type of Medicare health plan offered by private companies that contract with Medicare to provide Part A and Part B benefits.
- As of 2023, about 31 million people are enrolled in Medicare Advantage plans in the United States.
- The bill specifically affects payments to these Medicare Advantage organizations, potentially impacting the benefits or premiums for enrollees if organizations adjust their offerings in response to changes in payment calculations.
- While this legislation impacts the structure of payments to Medicare Advantage organizations, the actual effect on enrollees could vary based on how these organizations manage the adjustments.
Reasoning
- Around 31 million people are enrolled in Medicare Advantage plans in the U.S., and these policies potentially impact a significant segment of this population. However, not all these individuals will see direct changes to their premiums or benefits as organizations may absorb the changes differently.
- Given the budget constraints, the policy is unlikely to dramatically shift overall wellbeing scores rapidly, but can make subtle improvements over time in terms of financial stability for some.
- The policy might more significantly impact older populations who rely more on Medicare, while younger individuals or those with alternate insurances might not be immediately affected.
Simulated Interviews
Retired teacher (Phoenix, AZ)
Age: 72 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 7/20
Statement of Opinion:
- I'm concerned about any changes to my premiums. Fixed incomes don't leave much room for unexpected costs.
- If this leads to keeping my premiums stable, then that's great news.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 6 | 4 |
| Year 10 | 7 | 5 |
| Year 20 | 7 | 5 |
Retired engineer (Orlando, FL)
Age: 68 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 6/20
Statement of Opinion:
- Any policy that might lead to more out-of-pocket spending worries me.
- I hope this results in better management of our plans to keep costs low.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 4 |
| Year 5 | 7 | 4 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 5 |
Part-time librarian (Columbus, OH)
Age: 64 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 2.0 years
Commonness: 8/20
Statement of Opinion:
- Currently, my plan is quite good, and I welcome anything that ensures it stays that way.
- Any relief in premium increase is helpful.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 6 | 5 |
| Year 20 | 6 | 5 |
Retired business owner (San Antonio, TX)
Age: 70 | Gender: male
Wellbeing Before Policy: 8
Duration of Impact: 3.0 years
Commonness: 5/20
Statement of Opinion:
- I would hope this keeps the variety of coverage options flexible.
- Hopefully, organizations won’t cut back on coverage options.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 7 | 6 |
| Year 20 | 7 | 5 |
Retired nurse (Boston, MA)
Age: 75 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 4.0 years
Commonness: 4/20
Statement of Opinion:
- I'm hopeful that this will keep my costs from rising unexpectedly.
- There's always a concern about any reduction in my plan benefits.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 6 | 4 |
Retired farmer (Des Moines, IA)
Age: 81 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 4/20
Statement of Opinion:
- I don’t keep up with all the policy details, but anything that keeps costs down is welcome.
- Stable payments are critical since I can't work like I used to.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 4 |
| Year 5 | 7 | 4 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 5 |
Retired writer (Seattle, WA)
Age: 66 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 6/20
Statement of Opinion:
- I value coverage for my therapies and hope any changes keep that part of my life secure.
- It's reassuring to know costs might stay managed.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 8 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 7 | 5 |
| Year 20 | 7 | 5 |
Retired musician (Austin, TX)
Age: 69 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 6.0 years
Commonness: 5/20
Statement of Opinion:
- Medicare Advantage has been essential for hospital-related costs, so any stabilizing effect is welcome.
- I'm cautiously optimistic about this change.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 6 | 4 |
Retired chef (Portland, OR)
Age: 73 | Gender: female
Wellbeing Before Policy: 8
Duration of Impact: 2.0 years
Commonness: 6/20
Statement of Opinion:
- Having just gotten the plan, I'm optimistic that stable premiums will let me continue enjoying my retirement.
- This policy sounds like it might help, but time will tell.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 7 | 6 |
| Year 20 | 7 | 5 |
Retired singer (Nashville, TN)
Age: 77 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 4.0 years
Commonness: 3/20
Statement of Opinion:
- I'm always focused on what costs I might face as a retiree, so any policy aiming to manage things is intriguing.
- This should hopefully keep my healthcare stable for longer.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 8 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 7 | 5 |
| Year 20 | 7 | 5 |
Cost Estimates
Year 1: $1000000000 (Low: $800000000, High: $1200000000)
Year 2: $1020000000 (Low: $820000000, High: $1220000000)
Year 3: $1040000000 (Low: $840000000, High: $1240000000)
Year 5: $1080000000 (Low: $880000000, High: $1280000000)
Year 10: $1160000000 (Low: $940000000, High: $1360000000)
Year 100: $2000000000 (Low: $1600000000, High: $2400000000)
Key Considerations
- The policy affects the federal government rather than directly increasing healthcare costs for Medicare beneficiaries.
- Long-term costs depend heavily on demographic trends and growth in Medicare Advantage enrollee base.
- Healthcare policy and reimbursement standards are susceptible to changes, impacting cost estimates.
- Potential changes in Medicare threshold calculations could imply varied impacts on private healthcare markets.