m.a. quality demonstration from 2012 through 2014 to test and alternative method for calculating and a wording bonuses. the general accountability office, the gal, in response to a request by senator orrin hatch noted that the demonstration projects designed need, quite made it unlikely that the demonstrations would produce meaningful results, "-end-double-quote, and recommended that hhs canceled the demonstration. it also stated him a quote, we remain concerned about the agencies legal authority to undertake the demonstration. with a price tag of $8.35 billion over ten years. the medicare actuary noted that this demonstration would offset more than one third of the reduction in the payments projected to occur under aca from 2012 to 2014. effectively masking the first wave of aca mandated cuts until next year. a recent report by the kaiser family foundation warned that more than half a million beneficiaries may have to switch to another m.a. plan or return to the fee-for-service medicare i

first, the m.a. patient and our supper received higher levels of recommended preventive care, and had fewer disease specific complications. second, during acute episode required hospitalization, the patients in the m.a. plan spent almost 1% less time in the hospital than those in traditional medicare. in addition they had a list readmissions into the hospital. finally, the percentage of people who died in the year we studied were substantially higher in the traditional medicare sample than those in the medicare advantage of sample. this is a striking finding and one that we hope to export further in a longitudinal multiyear study. our studies that directly address the causes of these differences. in my experience, however, the key factor is m.a. itself and how the plans are organized and managed. first, these plans ally with financial incentives with clinical best practice. second recruit most effective providers and include only those who practice high polity medicine. third, they put a strong empha

m.a.se in th program of as much as 50%. it also provides quality bonus achieve to plans that four percent, 4.5%, and five percent stars on the quality cms.g system developed by rather than implement the bonus structure that would have led to these cuts going into effect in 2012, cms announced in november 2010 that it will conduct a nationwide demonstration. m.a. quality payment demonstration from 2012 through 2014 to test an alternative method for khaki leading and awarding bonuses. the general accountability office, the gao, in response to a request by senator orrin hatch , noted the demonstration "itect design made unlikely the demonstration would produce meaningful results" and recommended that hhs canceled the demonstration. gao also stated, "we remain concerned about the agency's legal authority to undertake the demonstration." $8.35 price tag of billion over 10 years, the medicare actuary noted this demonstration would offset more than one third of the reduction of payments projected

by reducing m.a. payments over time, there will be greater parity between m.a. traditional medicare payments resulting in savings that will benefit enrollees and help secure the solvency of the medicare trust fund for a longer period of time. critics of these payment reforms predicted that m.a. cost for enrollees would rise, that the provider networks for plan choices would decrease, and it may involve would drop. changes in provider participation pricing and coverage occur every year as an inherent part of insurers business decision-making, including long before the passage of the aca and that's why we're provided tools to seem as to ensure that seniors are protected from potential changes that private plans may make. in addition seniors continue to have a choice that best suits their individual needs and every year continued to maintain the ability to pick a new plan or traditional medicare. so i look for during more of from our witnesses on recent trends in medicare advantage. i think we can agree our work as a committee needs to continue beyond the improveme

>> m.a. has a track record and it's by and large a high quality track record as i said earlier, not every m.a. plan is created equal but it has a track record. acos our concept at this point, and unproven. there's one big difference. seniors choose their m.a. plan. seniors are assigned to the aco and they have no choice. that's a significant difference in the two concepts. >> thank you very much. i yield back. >> now recognizes the gentleman from north carolina, ms. ellmers, for five minutes. >> thank you, mr. chairman. and thank you to our panel for being here on this issue. serving the second district of north carolina, and i've been hearing since the rollout of obamacare that my constituents who are losing their medicare advantage are very, very concerned about this issue, as you can imagine. and it's showing in north carolina that the cuts to benefits for seniors for medicare advantage are over $2000 per beneficiary. now that we are seeing this play out, the things i'm hearing from my con

when i got to the other prison, i started making aa and m.a. meetings. i started going to church. studying. >> jones served 18 years of a 25-year sentence at a florida state prison before he was released on parole. he moved into the noah house, a residential substance abuse program, in tampa. >> they help ex-offenders get a fresh start in life. they help you stay straight, you know. i wanted to stay straight. i didn't want to go back to prison. i always, you know, participated. and so they finally gave me a job. my job title was peer advocate. and i basically helped ex-offenders. >> jones was doing well. he says he would ride his bicycle to various other halfway houses to recruit participants for programs at noah house. but eight months into his parole, things went horribly wrong one day when he decided to take a shortcut home through a large hole in a fence. >> i didn't know that that was a crime to cross over the railroad tracks because the whole neighborhood goes through that way, back and forth. children go to school back and forth from school that way. i see grown folks going

they are not looking for a year likee with a -- for a year with an m.a. plan. they are not locked in, they can choose who they want with aco's. you about how medicare damage could be improved. all this here agreed that the medicare damage program is a crucial alternative to traditional medicare especially for individuals with complex health care needs. in your opinion based on your organization's work in assisting medicare beneficiaries what recommendations do you have for how the medicare advantage program could be improved for beneficiaries? >> the promise of managed care when it was initially put forward in the mid--1990's, a big push was that it would save the federal government money and provide core care. we talked a lot about the advantages of medicare advantage but some of that promise has not been met. as we have talked some of the plans are better than others but overall, the level of coordinated care does very widely amongst clans and so we think better monitoring and oversight by the senate -- a center for medicare and medicaid services to make sure

they are not opting for a yearly er with an m.a. plan. that is my opinion. when i heard you say, talk about aco, i wanted to express my view, which is that they are not locked in. they can choose whoever they want in a traditional medicare plan. mr. baker, i want to ask you how medicare advantage can be improved. all of us here today agree the medicare advantage program is an alternative to traditional medicare, especially individuals with complex health care needs. in your opinion, based on your organization's work in assisting medicare beneficiaries on the way back from nations do you have brought the medicare advantage program could be improved for beneficiaries? >> of course. the promise for managed care when it was initially put forward in the mid-90s, the big push was that it would actually save the federal government money and provide for me to care an additional benefit to people with medicare. we talked a lot about the advantages of medicare advantage. some of the promise hasn't been met. some plants are better than others, but overall the level of