the value of medicare advantage
DESCRIPTION
The Value of Medicare Advantage. Karen Ignagni President and CEO America’s Health Insurance Plans July 16, 2007. Choices Before Congress. Maintain Choices in All Markets versus Reducing or Eliminating Choices. How to Evaluate Choices. Assess History Assess Value - PowerPoint PPT PresentationTRANSCRIPT
The Value of Medicare Advantage
Karen IgnagniPresident and CEO
America’s Health Insurance Plans
July 16, 2007
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Choices Before Congress
Maintain Choices in All Markets
versus
Reducing or Eliminating Choices
3
How to Evaluate Choices
Assess History
Assess Value
Consider Constituent Impact
4
Medicare Advantage: An Historical Look*
Medicare Advantage Enrollment History and Major Payment Changes
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4
5
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7
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1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007
Enro
llmen
t in
mill
ions
BBA payment methodology and rural floors-PFFS option begins
(-$97B) /10 years
BIPA Urban floors and higher rural floor payments
$32.5B/10 years
MMA $4.3B/10 years for MA Improvements $10 B/10 years for Stabilization Fund
(Now $ 3.5B per TRHCA)
Risk plansMedicare +Choice
Medicare Advantage
Part D
*Chart based upon CMS Medicare Advantage Fact Sheet (3/07).
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Bipartisan Congressional Efforts to Extend Access to Choices BBA 1997 – Congress established rural “floors” (rates intentionally set above FFS)
BIPA 2001 – Congress established MSA floor
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Congressional Intent Achieved
MA Plans in 2003 MA Plans in 2006
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Medicare Advantage Payment-2007 Floor Counties
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Congressional Intent Achieved --Access to benefits and savings
The overwhelming majority of seniors enrolled in Medicare Advantage plans are satisfied with their
coverage, and satisfaction is up since 2003.
90% 84%
7% 9%
2007 2003
Satisfied
Dissatisfied
53% Very Satisfied37% Smwht Satisfied
53% Very Satisfied37% Smwht Satisfied
49% Very Satisfied35% Smwht Satisfied
49% Very Satisfied35% Smwht Satisfied
Question: How satisfied are you with each of the following aspects of your Medicare coverage: Your Medicare coverage overall?
Question: How satisfied are you with each of the following aspects of your Medicare coverage: Your Medicare coverage overall?
Source: Ayres, McHenry & Associates (March 2007)
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Serving Vulnerable Populations
MA is important choice for low-income and low-income minority
beneficiaries
One-third of all seniors, and three-fifths of low-income seniors, would skip some health care treatments if they no
longer have access to a Medicare Advantage plan.
42%
26%
40%
52%57%
35%
62%
41%
29%23%23%
13%19% 19% 20%
All <$20K $20K-$30K $30K-$50K $50K+
Pay/Continue treatments Not pay/Skip treatments Don't know
Question: If Congress makes cuts to the Medicare Advantage program and you had to use traditional Medicare coverage, would you pay higher out-of-pocket costs so you could
continue to receive the same health care treatments you receive now, or would you not pay higher out-of-pocket costs and skip some of the health care treatments you receive now?
Question: If Congress makes cuts to the Medicare Advantage program and you had to use traditional Medicare coverage, would you pay higher out-of-pocket costs so you could
continue to receive the same health care treatments you receive now, or would you not pay higher out-of-pocket costs and skip some of the health care treatments you receive now?
Source: Ayres, McHenry & Associates (March 2007)
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MA Extra Benefits and Services -- Results
MA Enrollees Are More Likely to Receive Preventive Services Than FFS Beneficiaries w/o Supplemental
Coverage
73%
65%60%
70% 72%
55%52%
46%
58% 58%
0%
10%
20%
30%
40%
50%
60%
70%
80%
PnemoccocalImmunization
InfluenzaImmunization
Mammography * ColorectalScreening
ProstrateScreening
MA Enrollees FFS w/o Supplemental Coverage
Source: Based on 2005 Medicare Current Beneficiary Survey
* For females under 75
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MA and Medicare’s Financial Outlook: Long Term CostsWhat the Trustee’s
Report Says Data
MA Contribution
Factors adding to growth in expenditures:
Continued growth in the volume and intensity of services per beneficiary
–GAO found nearly 60% growth in spending on physician services 2000-2005 –NEJM reports beneficiaries in FFS see multiple doctors.
MA can provide medical home.
The impact of recent legislative changes including Part D
Part D costs lower by $113 B/10-year frame and $96 B result of competition and lower bids
MA reduces Part D expenditures
Demographics-aging of population
-NEJM reports uninsured age-ins have more chronic conditions.
MA plans manage these diseases.
Three-fourths of doctors think cuts to Medicare Advantage will harm seniors.
74%
16%11%
Negative effect No effect Don't know
Question: If Congress makes cuts to the Medicare Advantage program, do you think that will have a negative effect on seniors enrolled in a Medicare Advantage plan, or do you think that
will have no real effect on seniors enrolled in a Medicare Advantage plan?
Question: If Congress makes cuts to the Medicare Advantage program, do you think that will have a negative effect on seniors enrolled in a Medicare Advantage plan, or do you think that
will have no real effect on seniors enrolled in a Medicare Advantage plan?
Source: Ayres, McHenry & Associates (March 2007)