Yes, Medicare Advantage is struggling, but it remains a key social safety net program. It just needs less biased assessments and better advocates.
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 that Medicare Advantage is struggling, but it remains a key social safety net program. It just needs less biased assessments and better advocates.
Key Takeaways:
Medicare Advantage turned 25 recently and is facing great financial troubles.
CMS has proposed tight rates, restrictions on prior authorizations, risk adjustment reforms, and Star rating changes.
This has led to major retrenchment, with reduced benefits, products, and footprints.
MA growth has slowed but it still grew year over year and during open enrollment.
MedPAC has been arguing MA is overpaid for years but relies on outdated data and dubious assumptions. This has undermined MA.
Some overpayments existed, but much of it went to the biggest health plans that used aggressive coding.
A bipartisan duo of former HHS secretaries came to the defense of MA recently, saying CMS and Capitol Hill have gone too far.
Let’s hope the defense of MA messages sink in The MA program is an important safety net and its death is greatly exaggerated.
Connect With Marc:
Resources:
The Healthcare Labyrinth: A Guide to Navigating Health Plans and Fixing American Health Insurance
