Charting A Path Forward For Medicare Advantage: Expert Consensus On Policy Priorities And Trade-Offs

More than half of Medicare beneficiaries are enrolled in Medicare Advantage (MA), yet concerns persist about overpayments to MA plans, inadequate plan oversight, and limits on beneficiaries’ access to care. To identify MA reform options, we conducted a two-round e-Delphi panel with thirty-nine experts, including researchers, industry representatives, patient advocates, and former policy makers. Panelists rated fifteen policy reform ideas on their impact on beneficiaries, the federal government, and MA plans. Experts agreed that six policy ideas would benefit beneficiaries, three would benefit the government, and one would benefit plans. The most feasible near-term options are standardizing supplemental benefits, limiting the number of MA plans that insurers can offer, and reforming agent commissions. These incremental reforms could improve beneficiaries’ decision making and financial protections without harming the government or plans and could be implemented through Centers for Medicare and Medicaid Services administrative action. Nonetheless, achieving the cost savings critical for Medicare’s long-term financial sustainability will require policies that may cause market disruption and negatively impact MA plans.