Feds propose Medicare advantage payment cuts, could have election impact

Published on February 24, 2014 at 7:58 AM · No Comments

Medicare Advantage is the managed care program, run by private insurance companies, for seniors and disabled people.

Politico: Major Spending Cut Proposed For Medicare Advantage
An annual notice released Friday after the markets closed would reduce Medicare Advantage spending by 3.55 percent. The figure is based on trends in health care spending, which has grown at a historically low pace in recent years. The annual rate adjustment -; which is only one of the payment changes -; is calculated through a complicated set of formulas, and analysts were still sorting out the 148-page proposal that CMS released late in the afternoon to assess the total impact on the increasingly popular program for seniors (Norman, 2/21)

Kaiser Health News: Obama Administration Proposes 1.9% Cut In Medicare Advantage Payments
According to a new analysis from consulting firm Avalere Health, enrollment in Medicare Advantage plans rose in 2014 by 8.9 percent to 15.9 million enrollees, up from 14.6 million in 2013. Approximately 30 percent of Medicare beneficiaries are enrolled in the plans, which are offered by private insurance companies. ... Last year, Medicare officials initially proposed reducing Medicare Advantage payments by 2.2 percent, but after another strong industry lobbying campaign, the administration switched gears and raised the rate by 3.3 percent (Carey, 2/21). 

The Associated Press: Medicare Advantage Plans May Face Cuts
Administration officials say the plans don't need to be paid as much to turn a profit, because the growth of health care spending has slowed dramatically. They see the cuts as a dividend for taxpayers. ... The plans have become a key source of revenue growth for insurers who sell and administer the subsidized coverage. They offer basic Medicare coverage topped with extras like vision or dental coverage or premiums lower than standard Medicare rates. There are hundreds of different plans around the country, each with its own set of variables like different deductibles, premiums and co-insurance (Alonso-Zaldivar, 2/22).

The New York  Times: U.S. Proposes Cuts to Rates in Medicare Payments
Karen M. Ignagni, the president of America's Health Insurance Plans, a trade group, said, "The proposed Medicare Advantage cuts would cause seniors in the program to lose benefits and choices" and could lead to higher premiums and out-of-pocket costs for beneficiaries -; arguments rejected by the administration. ... Before Congress passed the health care law, independent experts said the government was spending more for patients in the Medicare Advantage program than it was for similar patients enrolled in traditional Medicare. Mr. Obama said private insurers were "overcharging massively" for the care they provided to Medicare beneficiaries. ... Budget blueprints developed in recent years by House Republicans, including Representative Paul D. Ryan of Wisconsin, retained Medicare savings enacted as part of the health care law (Pear, 2/21).

Reuters: U.S. Government Seeks To Cut Medicare Payments To Insurers
Friday's notice of proposed rates opens a window for negotiations on the final ruling, due April 7. ... The proposed payment rates are a key factor in how insurance companies plan their business for the coming year, including in which markets they will offer health plans, what their medical and administrative costs will be and at what level to set premiums and doctor visit co-payments. ... The Centers for Medicare and Medicaid Services said in a statement that the proposed changes for 2015 are smaller than those implemented in 2014. ... It said it would change a part of its risk payment formula to account for the increasing proportion of baby boomers entering Medicare, who tend to have better health (Caroline Humer, 2/21). 

 


http://www.kaiserhealthnews.orgThis article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

 

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