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Medicare Advantage plans don't save over traditional Medicare, report says

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The idea behind Medicare Advantage plans--in which the government pays private healthcare organizations a fee to manage care for Medicare beneficiaries--was that managed care groups might be able to care for beneficiaries more cheaply and effectively than traditional fee-for-service Medicare.

But that doesn't seem to be happening, if a new report is any indication. The report concludes that Medicare Advantage plans, which will be paid $11 billion this year, are getting $1,140 more per enrollee than it would cost to care for the same number of patients under FFS Medicare.

The study, which was funded by The Commonwealth Fund, concluded that paying Medicare Advantage 101 percent of fee-for-service costs--an idea floated by the Obama Administration--would save money in some cases, but in other states would not. For example, in 11 states, Medicare payments to MA plans would average more than 10 percent and $1,000 more per enrollee than average costs in FFS Medicare, and sometimes much more.

To learn more about this issue:
- read this Healthcare Finance News piece

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Of course the medicare advantage plans cost more than traditional fee for service medicare. The former provide a wider range of benefits, including basic dental coverage, eyeglasses, contacts, and hearing aids.
And I do not believe that the original idea behind medicare advantage plans was to provide medical services cheaper that the ffs plans. The original idea was to provide a broader range of health-related services at lower overall cost because of the advantage of bulk buying power. My optomotrist charges me, a private insurance beneficiary, $275 for a pair of eyeglasses and frames, of which my private insurer pays $100 of the cost. A medicare advantage participating optomotrist might charge the plan $125 in total, with no patient co-pay. The optomotrist sees his profit drop from $175 down to $25 for the order, but he now has hundreds of more potential customers in network in his immediate area. Do the math.
Don't believe everything that you see or hear, particularly when its coming from shills for the current administration.
That's just my opinion, of course.

Howard, before you accuse researchers of having a political agenda and being "shills for the current administration," you should be informed about the topic.

Medicare Advantage is the third generation of the Medicare risk plan program from the 70s, which was explicitly created to save money for the Medicare program. Despite being paid at 95% of area fee-for-service costs, however, the program didn't save a dime. Plans cherry picked healthy beneficiaries and, as a result, risk plans cost about 6% more than traditional Medicare.

The stated goal of private plans in Medicare has always been to save money, which would then be used, in part, to fund expanded benefits and reduced cost sharing for members. In the MA program, however, these extras are not funded from savings, but from subsidies paid by the government and are provided extremely inefficiently. Every $1 of extra benefits/reduced cost sharing costs the Medicare program (i.e., the taxpayers) $1.30.

The intent behind the MA subsidies enacted in 2003 was to make it profitable for insurers to create these plans and attractive for beneficiaries to join, thus privatizing the Medicare program over time.

All this has come at a huge cost, however. We can debate whether private plans are worth the money, but there's little doubt they cost far more than traditional Medicare, even when supplemental benefits and lower cost sharing are factored in.

As a disabled person on FFS Medicare:
Most Advantage plans have a substantail out of pocket monthly premium. (That's fine if you've got the money. It must be nice to be able to afford Medigap coverage or the Golden Premium Advantage plans etc. -Not implying anyone posting here does.) There are some plans for $0 out of pocket but they are the bare bones minimum. I was on an Advantage plan once, they lured me in with the $0 plan then slowly increased the out of pocket costs until the plan was $35 a month. Then they left the state and dropped everyone on the plan. The choice was find another Advantage plan or go back on Regular Medicare FFS. Why get a barebones Advantage plan and get squeezed out again? The same problem exists with the prescription drug plans. The first year of the plan I opted for the lowest cost plan because my drug usage is very minimal. 1st year $4 a month, 2nd year $10, 3rd year 16.70... Soon I may have to drop it because since day one I've been spending more out of pocket with a plan than without one. Not to mention that Social Security cost of living raises are a joke. They give you a rise then it get's eaten up with higher premiums and out of pocket expenses.

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