March 6, 2019

THANKS, W!:

Enhancing Medicare Advantage (Chris Pope, February 28, 2019, Manhattan Institute)

Medicare funds health-care services for 60 million elderly and disabled Americans. Of these, 39 million receive coverage through a plan known as "Traditional Medicare" or "Medicare Fee-for-Service" (MFFS) that the federal government administers directly. Increasing numbers--21 million in 2019--enroll in Medicare Advantage (MA), choosing Medicare coverage from competing plans managed by private insurers.

Medicare's Fee-for-Service payment system has hampered appropriate coordination of care and inflated costs by paying separately for each medical procedure or service delivered to beneficiaries, regardless of their value. As every detail of its operation is highly politicized and hard to reform, MFFS has an outdated benefit structure that leaves elderly and disabled enrollees exposed to potentially catastrophic out-of-pocket costs.

By contrast, MA plans have broad flexibility to upgrade operations. They are able to reduce costs and improve medical outcomes by making better use of primary care, negotiating discounts with preferred networks of providers, and managing chronic conditions to avoid expensive hospitalizations. This allows them to attract enrollees by reducing out-of-pocket costs and enhancing benefits.

Posted by at March 6, 2019 4:05 AM

  

« WE ARE ALL DESIGNIST NOW: | Main | THANKS, DONALD!: »