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Enhancing Transparency in Medicare Advantage Data

Arnold Ventures submitted comments to the Centers for Medicare & Medicaid Services recommending ways to enhance data transparency in Medicare Advantage.

Enrollment in Medicare Advantage (MA) plans continues to grow, and these plans now provide coverage for more than half of all Medicare participants. By the end of the decade, enrollment is expected to reach 60%. MA also serves as an important source of coverage for people who are dually eligible for Medicare and Medicaid. 

The program, while popular, remains a significant driver of overall Medicare spending. MA enrollees cost the federal government 22% more compared to enrollees in traditional Medicare from coding and favorable selection – a difference amounting to $83 billion in 2024 alone.

This means improving data transparency across the MA program is crucial to ensure appropriate oversight and that the program delivers value to enrollees. For years, the Medicare Payment Advisory Commission (MedPAC) has been emphasizing to policymakers the critical need for improved information that would monitor performance, evaluate payment policy, and assess quality of care. 

Today, MA data are less available than data for traditional Medicare. Earlier this year, the Centers for Medicare & Medicaid Services (CMS) put out a request for information with the goal of improving transparency into MA organizations and their operations, as well as to make MA data comparable to traditional Medicare and other programs. Arnold Ventures made several recommendations including: 

  • Ensure people are getting access to covered services through their MA plan.
  • Collect and release data on ownership arrangements in the MA market and related party transactions to increase transparency.
  • Create more transparency and accountability for plans that serve people who are dually eligible for Medicare and Medicaid. 

Read our full comment letter here for a complete list of recommendations.