Tag Archives: medicare advantage

Medicare Advantage proposal outlines strategies to promote value-based insurance and patient engagement

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

Buried deep in a proposal from the federal Centers for Medicare & Medicaid Services (CMS) last week was a proposal to consider new payment and delivery models designed to lower costs and improve quality.

Most of the news about the proposal issued Feb. 21 involved the CMS plan to cut payments to health plans serving Medicare Advantage members by 19 percent. But in the same proposal, CMS said it was seeking to partner with health plans to develop value-based insurance design (VBID) strategies and to improve member engagement.

In its annual call letter, CMS outlines changes for the coming year. In the call letter for 2015, Medicare Advantage Organizations, Prescription Drug Plan Sponsors, and Other Interested Parties (942 Kb PDF), CMS explained briefly its plans for these new strategies: VBID and patient engagement. These two strategies are not widely known, but some of the more innovative health plans have been adopting these two strategies in recent years as they seek to contain costs and improve the quality of care they deliver. Continue reading

How will health reform affect Medicare?

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

The Associated Press’ Carla Johnson looks at how health care reform might affect those currently covered by Medicare, focusing on five key areas: Medicare Advantage, prevention, hospitalization, electronic medical records and prescription drug coverage. Here are the basics:

  • Medicare advantage is popular but relatively expensive. Some private insurers may leave the program if funding is cut, forcing some seniors to change providers. Cuts may also hit extras like hearing aids and health club memberships.
  • Preventative services such as mammograms and diabetes classes will be better covered under most proposals.
  • Some plans may punish hospitals with high readmission rates and encourage all hospitals to work to keep patients from coming back.
  • Any move to electronic medical records and better coordination of care would benefit Medicare patients and providers, as Medicare suffers from many of the same inefficiencies as the system at large.
  • As for the notorious prescription drug coverage “doughtnut hole,” the house democrats have proposed a plan that would fill it in by 2023.

Showdown over Medicare Advantage looms

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

In support of a range of folks including President Obama and his local orthopedists, Gilbert Cranberg takes on Medicare Advantage plans in the Nieman Foundation’s Neiman Watchdog.

Cranberg urges the press to pay close attention to the impending showdown between the president and a coalition of insurance companies and Medicare Advantage clients grown accustomed to heavy government subsidies. The administration estimates cutting the Advantage program will save $176 billion over the next decade, money the president hopes to use to expand coverage.