Opponents of Medicare Advantage (MA) have opened a new line of attack on the program, arguing supplemental benefits are more of a marketing scam than a true value. MA plans need to take the issue very seriously and reform their programs.
About The Podcast:
Millions of Americans feel confused and frustrated in their search for quality healthcare coverage.
Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change.
Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Podcast offers accessible, incisive deep dives on the most pressing issues and events in American healthcare.
Marc seeks to help Americans become wiser consumers and navigate the healthcare maze with more confidence and certainty through The Healthcare Labyrinth website and his book of the same name.
Marc is an unconventional Republican who believes that affordable universal access is a wise and prudent investment. He recommends common-sense solutions to reform American healthcare.
Tune in every week as Marc examines the latest developments in the space, offering analysis, insights, and predictions on the changing state of healthcare in America.
About The Episode:
On this episode, Marc discusses the need for Medicare Advantage (MA) plans to reform how they approach supplemental benefits. Opponents have opened a new line of attack on the program, arguing supplemental benefits are more of a marketing scam than a true value.
Key Takeaways:
Opponents of the program, CMS, and Capitol Hill are very focused on overpayments in Medicare Advantage (MA).
But a new line of attack has opened on supplemental benefits, with arguments that supplemental benefits are more of a marketing scam than a true value.
CMS has liberalized the kinds of supplemental benefits that can be offered.
Supplemental benefit offerings have proliferated over the years but no one knows if what is submitted in bids as expected utilization represents what is truly utilized.
There are numerous reasons for this, including no submission of supplemental benefit data to the encounter data system.
Both the GAO and MedPAC have raised issues.
Opponents, too, are firing up their objections.
CMS has issued two reforms in response and to ensure better oversight, including mandatory submission of supplemental benefits to the encounter system as well as outreach and notification of members on the availability of the benefits.
MA plans need to take the issue very seriously and reform their programs. They need to drive utilization to show the real value.
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Resources
The Healthcare Labyrinth: A Guide to Navigating Health Plans and Fixing American Health Insurance