January 20, 2026

MedPAC Analysis Highlights Progress, Still Needs to Account for Differences in Medicare Advantage Versus Fee-For-Service

On Friday, Jan. 16, 2026, MedPAC shared updates to its methodology for comparing spending in Medicare Advantage versus Fee-for-Service Medicare. While the Commission made modest model changes, the analysis continues to fall short of capturing fundamental differences between the two programs.

Under MedPAC’s latest estimates, Medicare Advantage payments are projected at 114% of Fee-for-Service spending—down from prior projections. This change is driven by new data and the V28 risk-adjustment model, which has changed coding trends in recent years. While these adjustments reflect progress, they still rely on a framework that compares two profoundly different models of care.

MedPAC estimates that Medicare Advantage payments will be $76 billion higher than what spending would have been in Fee-for-Service in 2026. However, this comparison fails to account for the crucial benefits that Medicare Advantage provides to both taxpayers and seniors—including supplemental benefits, lower out-of-pocket costs, care coordination, and greater financial protections—nor does it reflect how MA’s value-based incentives change utilization patterns and outcomes for beneficiaries.

“While this is a step in the right direction, MedPAC methodology still fails to account for key differences between Medicare Advantage and Fee-For-Service,” said Rebecca Buck, Better Medicare Alliance’s Senior Vice President of Public Affairs. “Medicare Advantage provides more value for beneficiaries and the government, and we will continue to push for more accurate data to aid policymakers in their decision making.”

It is critical that analyses used by policymakers capture how Medicare Advantage works in practice and the value it delivers. Better Medicare Alliance will continue working with allies and policymakers to advance more complete, data-driven comparisons that recognize Medicare Advantage’s role in strengthening Medicare for seniors today and in the future.

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