CMS Has Begun To Collect Additional Data On Private Medicare Advantage Plans, Acting Administrator Says
Main Category: Medicare / Medicaid / SCHIPArticle Date: 03 Mar 2008 - 9:00 PDT
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CMS has begun to collect additional data on private Medicare Advantage plans, acting CMS Administrator Kerry Weems said on Thursday at a House Ways and Means Health Subcommittee hearing, CongressDaily reports. Weems comments were made in the context of a Government Accountability Office report released on Thursday that found MA plans can cost beneficiaries more than traditional Medicare for home health care, nursing homes and certain hospital stays. However, CMS "protested GAO's approach to the report, saying it did not focus on the advantages" of enrollment in MA plans, according to CongressDaily.
Democrats said that the report indicates the need for a reduction in reimbursements for MA plans. Subcommittee Chair Pete Stark (D-Calif.) said, "I see no reason that they have to be grossly overpaid and under-regulated." Stark added that he hopes the additional data collected by CMS will provide improved information about MA plans (Johnson, CongressDaily, 2/28).
Rep. Dave Camp (R-Mich.) said, "Clearly it's a fake report with fake conclusions, and we're having a fake hearing on it so we can all run to the media and make certain pronouncements," adding, "The report only looks at hypothetical beneficiaries, who use only certain types of services and enroll in a narrow selection of plans." He said that the report "does not reflect the reality of a single beneficiary" enrolled in MA plans and that opponents of such plans "will ignore the reality that the vast majority of plans actually provide much better cost-sharing benefits" (Reichard, CQ HealthBeat, 2/28).
In an e-mail, officials for America's Health Insurance Plans wrote, "By focusing on cost-sharing for individual services, without considering the entire episode of care, the report underestimates the value" provided by MA plans (Goldstein, Bloomberg/Hartford Courant, 2/29).
The GAO report is available online.
Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
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Influence Of The Private Health Insurance Lobby
posted by Anthony Sarola on 14 Mar 2008 at 6:51 pmIt appears that the interests of the private health insurance lobby has once again taken precedence over cost-savings and national health policy initiatives. The private health insurance plans that are supposed to be competing with traditional Medicare are more costly than traditional Medicare, and are being subsidized by our tax dollars,
The private health insurance industry must either compete fairly (without taxpayer subsidies) or let the government run Medicare without its interference. It has been shown that the federal government operates Medicare with significantly lower administrative costs than do private insurers. For one thing, the government does not have executives with multi-million dollar salaries and golden parachutes. However, with the taxpayers now subsidizing private Medicare Advantage plans, the government is indirectly contributing to the overinflated salaries of insurance company executives at the expense of the tax payer and the benficiary. While the free market may work best for most services, healthcare is the exception, and should not be dictated by the profit motive of the private health insurance industry. I can appreciate the idea of tapping private insurers to create innovative. programs with the goal of improved provision of care at lower overall cost. However, it is the obligation of our elected representatives to fairly assess the extent to which this experiment is working to the betterment of the citizenry rather than simply to the further enriichment of the health insurance industry.
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