REGULATORY REVIEW: Medicare Advantage in the Spotlight


Medicare Advantage in the Spotlight

Prior authorization policies could limit procedures ASCs provide

In the January 2023 issue of ASC Focus magazine, ASCA highlighted the growing proportion of Medicare beneficiaries enrolled in Medicare Advantage (MA) plans. MA plans, which covered less than 15 percent of Medicare beneficiaries in 2005 according to an issue brief from The Commonwealth Fund, now cover a majority of Medicare beneficiaries according to the Kaiser Family Foundation (KFF). A May 2022 report from the Congressional Budget Office (CBO) projects that proportion will rise to 60 percent by 2030. The rapid increase in MA plan enrollment has not gone unnoticed by industry stakeholders and policymakers, and as predicted in the January 2023 article, MA had become a central part of healthcare discussions in 2023. After a year of growth, ASCA can provide some background, policy highlights and recent developments to monitor as Medicare Advantage steps firmly into the health policy spotlight.

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