From Kip Sullivan: "The Kaiser Family Foundation reports that Medicare overhead in 2018 was 1.3 percent of total program spending while the overhead of Medicare Advantage plans was 14 percent (scroll down to Figure 3 and look just under Figure 3). https://www.kff.org/
The 14 percent figure is lower than the 20 percent figure for private-sector insurance, in part because insurance companies don't have to pay for premium collection.
So, inquiring minds would like to know: How the hell do Medicare Advantage companies save money for Medicare with overhead like that?"
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