For years, health insurance companies have claimed that Medicare Advantage (MA) can provide better care at a lower cost. But is this really the case?
It's hard to say, Wendell Potter writes in a post for the Center for Public Integrity. His reason: Neither the federal government nor insurers who operate MA plans will make cost-related data available.
In the past, MA advocates have defended the plans, saying they provide richer benefits to consumers because the federal government has been overpaying insurers to encourage their participation in the MA program.
Potter points to former America's Health Insurance Programs (AHIP) President Karen Ignagni's stance back in 2012. Ignagni told members of the House Ways and Means Committee that 78 percent of MA plan enrollees are in plans that cap their annual out-of-pocket maximums at $5,000. Beneficiaries enrolled in traditional Medicare plans pay way more.
At the time, Ignagni based her stats off a study from MedAssurant (now known as Inovalon), a company that provided data analysis to AHIP.
While such results prove to be attractive, "we can't be certain that enough data was made available to the researchers to give us confidence their findings are reliable," Potter writes.
Last week, a Commonwealth Fund report concluded that there is little or no competition in MA insurance markets in 97 percent of U.S. counties, FierceHealthPayer reported. This may or may not change with the latest merger deals to hit the industry, Stuart Guterman, one of the study authors, told FHP, but the point of the study, he noted, was that there was little competition to begin with.
- here's Potter's commentary