Nebraska hospitals warn seniors that Medicare Advantage isn’t for everyone

[AgentGeneral]

Oh no, my rich spouse is going to die, bc I just put him on MAPD/GTL.

Oh wait a minute....I'm also a Life insurance agent and did that up years ago.

Im safe. Whew.

 

[sshafran]

Oh no, my rich spouse is going to die, bc I just put him on MAPD/GTL.

Oh wait a minute....I'm also a Life insurance agent and did that up years ago.

Im safe. Whew.

Sounds pre-meditated:

"It was agent general in the office, weapon was MAPD, motive was the death benefit."

 

[somarco]

"It was agent general in the office, weapon was MAPD, motive was the death benefit."

Are you playing CLUE?

As in, Col. Mustard in the Library with the Candlestick . . .

 

[sshafran]

Are you playing CLUE?

As in, Col. Mustard in the Library with the Candlestick . . .

Yes, you caught the analogy...

 

[Packerland]

Ok let’s. get serious about Rural Hosptial. I grew up in a really area and for the most part had to travel between 60 and 150 miles if something major was going on. Sure these hospitals call themselves hospitals but let face it they Dr for the most part and the facilities are not state of the art.

In my humble option the following is the problem and in no certain order.

1. Rural areas often have a higher proportion of elderly residents, many of whom are on Medicare. Medicare reimbursement rates are typically lower than private insurance, which can lead to lower revenues for hospitals that serve a predominantly older population.
2. Rural hospitals often do not have specialists or the necessary equipment to handle complex medical cases. This limitation means they cannot offer certain high-revenue services like advanced cancer treatments.
3. For serious conditions like cancer, patients tend to prefer hospitals with specialized facilities and staff. Consequently, they travel to urban centers for treatment. This preference deprives rural hospitals of the opportunity to treat high-revenue cases.
4. The combination of these factors leads to a significant economic impact on rural hospitals. With a limited patient base primarily using Medicare and an inability to offer specialized services, these hospitals struggle to generate sufficient revenue to sustain operations.
5. This situation calls for a reevaluation of how healthcare is delivered and financed in rural areas. There could be a need for policy interventions, such as higher Medicare reimbursement rates for rural hospitals or incentives to attract more specialized physicians to these areas. Have you noticed when quoting a Med Supplement the rates are always much lower in a rural area. Just maybe Medicare should look at this and actually raise the reimbursement rates for Medicare services in these rural areas and or raise the rates on all Medicare Supplements in order to subside the rates that these hospitals receive.

 

[somarco]

Medicaid disproportionate share hospital (DSH) payments are statutorily required payments intended to offset hospitals’ uncompensated care costs to improve access for Medicaid and uninsured patients as well as the financial stability of safety-net hospitals. In fiscal year (FY) 2021, Medicaid made a total of $18.9 billion in DSH payments ($8.1 billion in state funds and $10.8 billion in federal funds).1
https://www.macpac.gov/subtopic/disproportionate-share-hospital-payment


Obama cut DSH funding once "his" law was enacted because he said DSH funding would no longer be needed since everyone would have insurance.

In 2022, 26 million people — or 7.9 percent of the population – were uninsured, according to a report in September 2023 from the Census Bureau

DSH funding had to be restored after realizing the master plan wasn't working as well as expected.


Over 250 hospitals and health systems came together this week urging House and Senate leaders to again postpone or eliminate billions in funding cuts to the Medicaid disproportionate share hospital (DSH) program set to go into effect Oct. 1.

The DSH program has been in place for decades to offset the uncompensated care safety net hospitals provide. The Affordable Care Act installed cuts to those payments that to date have been punted 11 times by lawmaker intervention from both sides of the aisle—sometimes in dramatic, down-to-the-wire fashion.
https://www.fiercehealthcare.com/pr...ge-divided-congress-come-together-dsh-funding

 

[AgentGeneral]

Sounds pre-meditated:

"It was agent general in the office, weapon was MAPD, motive was the death benefit."

Yep, the big annual pay spouse contributes isn't enough. had to make 600 plus the gtl commish. LOL. You know, bc MAPD agents = greedy monsters.

 

[Yagents]

New phrase for your MAPD day:

"payment integrity administrative review."

https://www.medpagetoday.com/special-reports/features/107547?

 

[somarco]

"payment integrity administrative review."

Carriers always know how to bend the rules and make their products attractive to gullible consumers who prefer to order from the dollar menu or frequent all you can eat buffets.

Carriers are also smarter than the goobers in DC that make the silly rules.

 

[Yagents]

Another one........may bite the dust. MAPD hospital roulette

[EXTERNAL LINK] - SMH and UnitedHealthcare at odds on new Medicare Advantage contract