A recent House hearing on Medicare Advantage shows what is in store for plans. It may not be good.
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 a recent House hearing on Medicare Advantage and what may be in store for plans. It may not be good.
Key Takeaways:
Capitol Hill has become far more active on MA issues, although major reform legislation has yet to pass.
Democrats spoke of their usual gripes – overpayments MA and the need to augment the traditional Medicare fee-for-service (FFS) program.
Republicans, who generally supported the program, were on board for many of the same reforms Democrats proposed.
Lawmakers want action on MA overpayments.
Lawmakers complained that supplemental benefits are not truly being spent on enrollee care.
Lawmakers and MA executives pitched the idea of multi-year enrollment to stop marketing abuse, high expenses, and to promote care management.
PA and claims denials were cited as the biggest concern by providers.
Some argued that value-based care (VBC) payment mandates could promote the recovery of independent primary care practices.
Some lawmakers feel the largest plans are abusing the system and giving the program a bad name.
A number of bills have been filed to respond to these concerns.
MA actually saves both Medicare and consumers quite broadly, and quality is markedly better.
It is ironic that CMS now wants to introduce PA in the traditional Medicare program, arguing FFS is wasteful.
Show Links:
Better Medicare Alliance website
Better Medicare Alliance statement
Elevance Health Public Policy Institute Study
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Resources:
The Healthcare Labyrinth: A Guide to Navigating Health Plans and Fixing American Health Insurance
