Overview of selected benefit redesign proposals
Numbers are not adjusted for inflation
Note: *This is a percentage of the federal poverty level.
**Additional specific payment structure adjustments are recommended to skilled nursing facilities, hospice, durable medical equipment, home health care, and visits to specialists.
***This means that if the plan includes a transition period, the estimate is for the year the transition ends. Plans vary widely in effect over time and in the distribution of costs or savings for payers other than the federal government.
**** This cost-sharing structure changes dramatically, with lower cost-sharing if beneficiaries make use of ACOs or care providers identified as “high-value providers”. The idea is to shift towards more efficient providers and therefore lower the overall cost of Medicare. Whether this produces the efficiency gains expected is up for debate, see Garrett et al. (2025) and Spivack et al. (2023).
**Additional specific payment structure adjustments are recommended to skilled nursing facilities, hospice, durable medical equipment, home health care, and visits to specialists.
***This means that if the plan includes a transition period, the estimate is for the year the transition ends. Plans vary widely in effect over time and in the distribution of costs or savings for payers other than the federal government.
**** This cost-sharing structure changes dramatically, with lower cost-sharing if beneficiaries make use of ACOs or care providers identified as “high-value providers”. The idea is to shift towards more efficient providers and therefore lower the overall cost of Medicare. Whether this produces the efficiency gains expected is up for debate, see Garrett et al. (2025) and Spivack et al. (2023).
