Schaeffer Center Study: Medicare, Medicare Advantage Physician Reimbursement Rates Nearly Equal

Medicare Advantage plans managed by private insurers pay physicians prices that are similar to traditional Medicare rates, according to a new USC-led study.

More and more Medicare beneficiaries are enrolling each year in Medicare Advantage, but experts knew little about their physician reimbursement differences or similarities.

“With 1 in 3 beneficiaries enrolled in Medicare Advantage, it is important to look under the hood and get a better understanding of how these plans operate,” said Erin Trish, the study’s lead author and an assistant research professor at the USC Schaeffer Center for Health Policy & Economics. “We found that physician reimbursement rates in Medicare Advantage are very similar to traditional Medicare. This is very different than what we see in the commercial insurance market, where insurers tend to pay physicians more than Medicare – sometimes much more.”

The traditional Medicare program is administered by the federal government. The Medicare Advantage program instead gives beneficiaries a choice of enrolling with a private health plan that has contracted with the government to provide health insurance benefits to Medicare beneficiaries.

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