Medicare Advantage
Specialty Plan Providers such as Medicare
Advantage coordinated care plans have a unique
focus and delivery plan for healthcare coverage to
Medicare beneficiaries. Medicare currently covers
44 million people, and represents over 70% of our
country’s health care expenditures. The government
pays private insurance companies a set amount to
offer Medicare plans -- a sum that has turned out
to be more than it costs to provide the required
basic health care benefits. Insurance companies
have used that subsidy in part to provide added
benefits -- including dental, hearing and vision
services, lower co-payments and rebates on monthly
premiums -- that have enticed over 9 MM senior
citizens to enroll.
The Congressional Budget Office (CBO) estimates
the government pays out about 14 percent more for
beneficiaries on Advantage plans compared to those
on traditional Medicare. The CBO projects that
bringing the program in line with traditional
Medicare would save the federal government $123
billion over 10 years. Insurers would scale back
those added benefits, analysts say, which would
result in an estimated 2.7 million people choosing
to return to traditional Medicare.
But even without health care reform, the movement
to scale the program back is likely to have
traction. Many don't think the government should
be paying more for Medicare Advantage than for
traditional Medicare. Reimbursement should be
equal and fair, and what the government pays
should be equal and fair and that can be done
without sacrificing essential benefits. An
amendment sponsored by Sen. Max Baucus, D-Mont.,
would require private insurance companies to
guarantee benefits equal to those available
through traditional Medicare.
In either Case, the increased benefits or cutbacks
in cost are forcing Medical Advantage plan
providers to become more innovative in their
approach to become more efficient, reduce costs,
and provide better outcomes. The
OutcomeAdvantage's platform provides this bridge
to enable enhanced co-ordination of care and
better communications with members. The results
are tangible and provide increased preventive
screenings, earlier intervention, and fewer
hospitalizations and ER visits. As partial or
total Risk Bearing entities, Medicare Advantage
plans work under different financial incentives
that actually encourage rapid technology adoption
to become more efficient, automated manual
processes, and raise the bar for better outcomes
at lower costs. OutcomeAdvantage is your partner
company to achieve these goals and more….
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Henry
J. Kaiser Family Foundation -
July 2009:
Strategies for Simplifying the Medicare
Advantage Market
Marsha Gold, Sc,D.
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Read Article
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