Medicare Advantage and the "Medicare Money Machine": Guests Dr. Don Berwick & Dr. Rick Gilfillan

Investor money and venture capital funding is pouring into Medicare Advantage (MA) plans. Enrollment in MA plans has more than doubled from 12 million members in 2011 to 26 million in 2021. What does this mean for us and our patients? Do these plans deliver better care for vulnerable older adults? Or are they a money making machine driving up healthcare costs in the name of profit? 

On today’s podcast, we are joined by UCSF geriatrics fellow Alex Kazberouk to talk with Dr. Don Berwick (founder of the Institute for Healthcare Improvement, former administrator of Center for Medicare and Medicaid Services) and Dr. Richard Gilfillan (former CEO of Geisinger Health Plan and Director of the Center for Medicare and Medicaid Innovation). Their recent two part post on the Health Affairs Blog about the Medicare “Money Machine” has stirred up a debate about challenges and misaligned incentives within Medicare Advantage.

We talk about:

1. What Medicare Advantage is all about - its history, operations, potential benefits, and what it means for us and our patients
2. Rick and Don’s Health Affairs post on the downsides of MA plans and the Medicare “Money Machine”
3. Policy solutions to improve the system without throwing the baby out with the bathwater

We also touch upon prior podcast topics such as the area deprivation index and population health. As a special, Alex plays a superb rendition of this song which is definitely not a Rickroll.

This is part one of a two part series on Medicare Advantage and healthcare financing. We have a follow-up with Claire Ankuda and Cheryl Philips on Special Needs Plans and the Medicare Advantage Hospice Carve-In coming soon.