Gauging Payment Reform Progress in Medicare Advantage: Current State and Opportunities for Improvement

Medicare Advantage plans are well-positioned to lead the transition from fee-for-service to alternative payment models. The program currently enrolls more than 1/3 of all Medicare beneficiaries and the flexibility given to plans makes it ideal for testing new models. However, the limited amount of publicly available information means little is known about what payment models are working well and why.

Maximizing the potential of Medicare Advantage to lead this transition requires better evidence that can help determine which reforms are promising and which ones to avoid. CMS can also play a critical role by releasing more data and finding ways to reduce provider burden to make it easier to participate in new payment models.