Medicare Advantage Plan Premium Distribution Experience

Linked IPAs has been a cooperative of three Provider Medical Teams (PMT) for the last six years. The HMOs that offer the Medicare Advantage Plans to patients who are cared for by our PMT physician members provided us with the financial data for production of the report you see below. The most remarkable part of the experience reported is the huge percentage of the premium dollar paid by Medicare that goes toward insurance company administration and profits. The patient care under this system was far superior to what patients normally receive in the open market and far less expensive, but the vast majority of the work was done by the physicians, and their part of the premium was about 1/4. A correction of this system is needed for the sake of both the patients and physicians. The Insurance companies and the hospitals need to offer better physician contracts and patient benefits.

See our Book, The Development of Physician’s ACOs, published on this web site for details about the cost of Medicare Advantage Plan services.