Medicare Advantage reporting honored in health journalism contest

Introduction

Senior reporter Fred Schulte’s investigative series into systematic waste in the Medicare Advantage program has been awarded second place in the Awards for Excellence in Health Care Journalism, business category, for the second year in a row.

The awards recognize the previous year’s best health reporting in 11 categories, and are given by the Association of Health Care Journalists.

Schulte’s project for the Center found that billions of dollars paid to privately run Medicare Advantage plans are wasted every year through manipulation of “risk scores. “ Risk scores” are a formula meant to pay health plans more for sicker patients and less for healthy people – but the formula often pays too much. Medicare Advantage plans now cover more than 16 million seniors at an estimated cost to taxpayers of more than $150 billion last year.

Since the Center’s stories were published, Senate Judiciary Committee Chairman Charles Grassley, R-Iowa, has rebuked the Centers for Medicare and Medicaid Services (CMS) for not reigning in overpayments fast enough. In addition, Sen. Claire McCaskill, D-Mo., asked federal officials to increase oversight of the Medicare Advantage plans. In a letter last year to Health and Human Services Secretary Sylvia Burwell, White House budget director Shaun Donovan wanted a “more aggressive strategy” to combat government overpayments to doctors, hospitals and insurance companies. The Government Accountability Office is expected to release the results of an audit of Medicare Advantage billing errors and overcharging by insurers this year.

The Center’s reporting on Medicare and Medicare Advantage has previously won the Philip Meyer Journalism Award for social science reporting twice, an Excellence in Financial Journalism Award, and the print journalism award from the National Institute for Health Care Management.