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- Janet on What Sequestration Could Mean to Medicare Advantage Claims Payment
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- Jane Wall Medicare Health Benefits Inc on Strange Bedfellows Come to Medicare Advantage’s Rescue
Tag Archives: Health Policy
Two new Health Affairs studies this month brought further evidence that Medicare Advantage (MA) is crushing traditional fee-for-service Medicare in quality, and that the world’s largest experiment in risk adjustment is working in MA.
Special Needs Plans (SNPs) are a special type of health plan for America’s most vulnerable and complex seniors that are set to expire at the end of 2013. Over 500 SNPs serve more than 1.5 million Medicare beneficiaries across the United States. Done well, the SNP significantly improves outcomes and brings down costs thanks to personal care planning, care-transition assistance, disease management, and medication therapy management. Not all SNPs are good at what they’re designed to accomplish, but there are many providing patient-centered, coordinated care to vulnerable populations showing signs of success — the program should be allowed to continue.
The FY 2013 budget battle lines are being drawn up now here in DC and Democrats are licking their chops over the idea of another GOP budget that attempts to dramatically reform the Medicare program. House Budget Committee Chairman Paul Ryan (R-WI) said this week that his budget will address Medicare and could include the revised plan he crafted with Sen. Ron Wyden (D-OR). Under their plan, seniors would get “premium support” to decide between buying private insurance coverage through Medicare Advantage or traditional FFS Medicare at inevitably higher out-of-pocket costs. In an election year it portends another Medicare cage match smackdown heading into November.
A CMS official announced Tuesday that final regulations for the Medicare Accountable Care Organization (ACO) Shared Savings Program are now expected mid-October. It looks like ACA’s requirement that the SSP launch January 1 is now out of reach, and there’s scuttlebutt here in DC that the launch date will be pushed to June or July 2012. These regs can’t come fast enough — and must be dramatically redrafted from the disastrous April draft — or Medicare could be left behind as the ACO revolution surges just about everywhere else.
The Congressional deficit “Super-Committee” formally began its work last week, and President Obama is expected to release his deficit reduction proposal today at 10am EDT. The President’s plan is expected to seek as much as $3 Trillion in savings — including, most notably, the new “Buffett Rule” establishing a new tax bracket for millionaires. The plan also includes $320 Billion in health savings over the next decade including $248 Billion in Medicare (would add 3 years to the trust fund) and $72 Billion in Medicaid cuts. The plan calls for exempting existing enrollees from some changes.
President Obama and House Speaker Boehner may have failed to strike a “grand bargain” on the nation’s deficit, but they have accomplished one thing in our world: they have forever changed the terms of the Medicare debate. There is an air of inevitability about some of the proposals they have put forth brewing here in DC.
Just as we were speculating Friday on timing for the Exchange eligibility and enrollment regs, out it came. The NPRM is a massive and visionary document that starts a discussion about how to revolutionize the way Americans select, enroll and pay for insurance.