Medicare Advantage Not the Glowing Success

[somarco]

"The reason I feel a sense of urgency is, we keep coming back to this issue that MA has never yielded aggregate savings to the Medicare program, despite that being one of the core goals," said Commissioner Cheryl Damberg, PhD, director of the RAND Center of Excellence on Health System Performance.

Lynn Barr, MPH, founder of Caravan Health, which was acquired by CVS Health through its acquisition of Signify Health, noted that "this is not the big lovely, you know, glowing success that everybody says it is. And we continue to create policies that drive people into these plans."

She referred to the fact that Medicare allows money paid to MA plans to be used for broker commissions as high as "$600 to recruit them, and they get $300 a year every year that they stay [in the MA plan]."

"We have allowed MA to buy the market," she added. "And that is why MA is growing. It's not because the quality's so great. People don't love the prior auth, people are leaving their plans a lot."

Stacie Dusetzina, PhD, of Vanderbilt University Medical Center in Nashville, Tennessee, noted that some MA beneficiaries may have trouble getting cancer care in MA plans' limited networks.

She referenced a recent news story about an MA enrollee who couldn't get the cancer care he needed from his MA plan, and couldn't get out of it without facing 20% in expensive copays. In all but four states, supplemental plans that could pick up the difference can reject patients with costly conditions.

"When you're 65 and aging into the program, you're healthy at that time, you may not be thinking about your long-term needs, which would push you to think harder about the specialty networks that you may have access to [in an MA plan] or not," she said.

MedPAC Report on Medicare Advantage Growth, High Costs Generates Kerfuffle

Commissioners reveal growing unease with MA practices: Not the 'glowing success' everybody says

www.medpagetoday.com

Also, read the comments section . . .

 

[Ron Van D]

These are the articles I share at my seminars. Attendees are shocked that Joe Namath hasn't told them about the downside of free stuff.

 

[Russ]

She referred to the fact that Medicare allows money paid to MA plans to be used for broker commissions as high as "$600 to recruit them, and they get $300 a year every year that they stay [in the MA plan]."

And this amount has made my life easier. That's the truth.

Love writing the plans. No great issues so far.

Now...back to the bitching and arguing about it.

 

[AgentGeneral]

Don't hate the player, hate the game.

Yet here we are, still the train keeps a rolling all night long....

 

[goillini52]

Don't hate the player, hate the game.

Yet here we are, still the train keeps a rolling all night long....

 

[thomasm]

She referred to the fact that Medicare allows money paid to MA plans to be used for broker commissions as high as "$600 to recruit them, and they get $300 a year every year that they stay [in the MA plan]."

And this amount has made my life easier. That's the truth.

Love writing the plans. No great issues so far.

Now...back to the bitching and arguing about it.

But MA plans are more benefit rich down in gator country, aren't they? I heard they pay beneficiaries to sign up for MA in FL!

 

[bill3173]

She referred to the fact that Medicare allows money paid to MA plans to be used for broker commissions as high as "$600 to recruit them, and they get $300 a year every year that they stay [in the MA plan]."

And this amount has made my life easier. That's the truth.

Love writing the plans. No great issues so far.

There's nothing illegal about either MS or MA, people are better off having one or the other, and it's an individual choice. It seems that most of these "arguments" are for entertainment.

There is an odd parallel between these arguments, and the Term vs. UL. Some agents use to talk about the "evils" of having term only, rather than WL or UL, but that was when UL's paid a much larger renewal commission.