Answered step by step
Verified Expert Solution
Link Copied!

Question

1 Approved Answer

In 2016, Centers for Medicare & Medicaid Services (CMS) proposed new advantage plan rates to insurers, which represented a 1.35% increase for 2017. These average

In 2016, Centers for Medicare & Medicaid Services (CMS) proposed new advantage plan rates to insurers, which represented a 1.35% increase for 2017. These average increases were considered "modest but stable growth" for insurers, and came with the consolation from CMS that insurers would actually see increases of about 3.55% as they deliver and bill for more intense services. Medicare is considered a major growth engine for the insurance industry as more baby boomers reach age 65. There are currently about 18.2 million people in MA plans with annual enrollment growing at 5%. The rates that Medicare pays to insurers are capitated, but they include a lot of regulatory tweaks that can push payments up or down for particular companies depending on their mix of business. For example, one proposal is to increase payments to insurers who have a large number of low-income enrollees that also qualify for Medicaid. Companies who do not have any poor enrollees may see their payments from Medicare decline.

Which hallmark of regulatory capture is evident in the tone of CMS and its proposed rate increases? Assume that United Healthcare is in favor of the proposed incentives to sell advantage plans to poorer enrollees, and that ABC insurance is opposed. Which hallmark of regulatory capture is United Healthcare exhibiting?

Step by Step Solution

There are 3 Steps involved in it

Step: 1

blur-text-image

Get Instant Access to Expert-Tailored Solutions

See step-by-step solutions with expert insights and AI powered tools for academic success

Step: 2

blur-text-image

Step: 3

blur-text-image

Ace Your Homework with AI

Get the answers you need in no time with our AI-driven, step-by-step assistance

Get Started

Recommended Textbook for

Essentials Of Accounting

Authors: Robert N Anthony, Leslie K Breitner

10th Edition

136071821, 9780136071822

More Books

Students also viewed these Economics questions

Question

Context, i.e. the context of the information presented and received

Answered: 1 week ago