U.S. government rolls back proposed Medicare Advantage cut

[PoliticAverse]

Source: Reuters

(Reuters) - The Obama administration on Monday rolled back some of the more controversial cuts proposed for privately managed Medicare health plans used by the elderly following pressure from insurance companies and lawmakers.

The Centers for Medicare and Medicaid Services (CMS) said that on average, reimbursement for such Medicare Advantage plans in 2015 would rise 0.4 percent, reversing what is said was a 1.9 percent average reduction proposed in February.

Analysts were still parsing the numbers, but said that the final decision appeared to be a win for insurers, who along with a broad swath of Republicans and Democrats in Congress had lobbied the government to keep payments level. The proposed cuts had also figured into Republicans' criticism of President Barack Obama's healthcare law.

"They were asking for flat (reimbursement) but no one ever thought they would get close to it," said Ipsita Smolinski, managing director of Capitol Street, a healthcare consulting firm based in Washington, D.C.

Read more: http://news.yahoo.com/government-says-2015-medicare-payments-insurers-rise-203302499--sector.html

[Thinkingabout]

1. This is good news.

Seniors are a large percentage of the GOP voters, they yell very loudly.

[pangaia]

2. But, but.. I thought it was......Socialism ....

I thought it was 'keep the government outta my Medicare'??

[IronLionZion]

3. Soon they'll want to keep the government out of their health insurance marketplaces

since its so much better than obamacare, which is socialism.

[pangaia]

4. the speed of sound is too fast

[SoapBox]

5. I never understood this bashing of the Advantage plans.

I've had my 90+ year old Mom on Advantage plans for several years.

We've had to pick an insurer (through Medicare)...then a doctors group...and then the doctors. It's like an HMO and you have to stay in the group.

If there is some kind of "management" issue then that needs to be solved but I'll be damned if I'm gonna beg for doctors and care for her, using straight Medicare.

[TiberiusB]

6. Medicare Advantagewould appear to be a ripoff and a sop to the insurance industry

http://www.latimes.com/business/hiltzik/la-fi-mh-medicare-advantage-20140326,0,4015039.story

[antigop]

11. yes, it is...too bad people don't understand or choose not to. nt

[antigop]

7. "... the final decision appeared to be a win for insurers," nt

[Hoyt]

8. Yeah, like paying unemployment is a win for local grocery store, mortgage holders, utilities, etc.

[antigop]

9. Pay No Attention to Those Insurance Lobbyists Behind the Medicare Curtain!

http://wendellpotter.com/2014/01/pay-no-attention-to-those-insurance-lobbyists-behind-the-medicare-curtain/

Brian Biles, professor of health policy at George Washington University, explained in testimony before the Senate Committee on Aging last Wednesday that Medicare has paid private plans more than the costs of traditional Medicare since 1997 when Congress authorized extra payments to entice private plans to operate in rural areas. Six years later, those extra payments were extended to just about all private Medicare plans.

Biles testified that those extra payments to Medicare Advantage plans nationwide averaged 13 percent—or $1,100 per enrollee—in 2009. The Congressional Budget Office projected that year that the excess payments would total more than $150 billion over ten years.

As lawmakers were debating health care reform in 2009, they inserted a provision in what became the Affordable Care Act to get rid of those overpayments. Alarmed, AHIP has been hard at work ever since trying to figure out how to keep the Centers for Medicare and Medicaid Services (CMS) from carrying out that provision of the law.

And for good reason. Insurers like UnitedHealth and Humana with a substantial number of Medicare Advantage enrollees are able to convert those excess payments into hefty profits. Financial analysts at Goldman Sachs estimated a few years ago that 66 percent of the net income at Humana, where I used to work, came from its Medicare Advantage business.

[antigop]

10. Selective outrage over federal health care costs

Commentary: Republicans feign outrage over Obamacare's risk fund for insurers, but have nothing to say about waste in Medicare Advantage

http://www.publicintegrity.org/2014/01/20/14135/selective-outrage-over-federal-health-care-costs

Republicans have long supported efforts to privatize Medicare, and the Medicare Advantage program is one of the ways they’ve tried to do it. Medicare Advantage is billed as a private alternative to traditional Medicare. When Americans reach 65, they can enroll in traditional Medicare or in a private plan operated by an insurer. If they opt for a private plan, the federal government still picks up the tab and transfers money to the private insurer every month.

As the U.S. Government Accountability Office explains it, the Centers for Medicare and Medicaid Services (CMS) adjusts the monthly payments it sends to private insurers to account for each beneficiary’s health status. As part of this risk adjustment process, CMS assigns each Medicare Advantage beneficiary a risk score — “a relative measure of expected health care costs,” as the GAO puts it.

We’re talking a lot of money here. In 2012 alone, the GAO calculated that the federal government spent about $135 billion on the Medicare Advantage program. The problem for taxpayers is that, according to the GAO, the government has been more than generous over the years to private insurers, having paid them way more than it should have because of shortcomings in how the risk scores are developed.