Yes. Medicare basically pays carriers what they would pay and then let the carriers manage their care. Any savings are split between the feds and the carrier. There are adjustments made to the payments based on quality metrics (called Stars).
The public/private model is very much the future IMHO. We see it in Medicare, Managed Medicaid and to some extent the ACA where the feds set the rules and then provide premium support.
The public/private model is very much the future IMHO. We see it in Medicare, Managed Medicaid and to some extent the ACA where the feds set the rules and then provide premium support.