The Number

The Number: 23%

Submitted by Rob Wyse on Wed, 07/18/2018 - 08:11

Medicare Advantage beneficiaries had twenty-three (23%) percent fewer inpatient stays than those enrolled in Traditional Fee-for-Service (FFS) Medicare, found a report released this week by Avalere Health. Though Medicare Advantage has a higher percentage of beneficiaries with chronic conditions enrolled due to disability than FFS, Medicare Advantage members experience better health outcomes at similar or lower costs then FFS.

The study, funded by Better Medicare Alliance (BMA), also found that Medicare Advantage had a lower rate of avoidable hospitalizations, higher rates of preventative screenings and fewer emergency room visits than FFS beneficiaries.

"This study adds to the growing body of evidence showing the ability of Medicare Advantage to align incentives to better manage the care for a high-need population with multiple chronic conditions," said Allyson Y. Schwartz, BMA President and CEO.

Adds Avalere founder, Dan Mendelson, “Our findings present new evidence for Medicare Advantage's value proposition, especially for high-need beneficiaries."

The Number: 54%

Submitted by Rob Wyse on Mon, 07/09/2018 - 10:28

Fifty-four (54) percent of beneficiaries of Medicare Advantage believe their health plan is working with them to limit out-of-pocket spending, according to a new JD Power consumer survey. This survey was the focus of a recent HealthPayerIntelligence article on customer satisfaction with Medicare Advantage plans.

Medicare Advantage satisfaction as a whole dropped slightly from 2017 to 2018, JD Power found. On a 1000-point scale, Medicare Advantage satisfaction scores for all plans fell from 799 to 794,” writes Thomas Beaton.

While satisfaction declined slightly, providers are also presented with an opportunity. The survey found that the Medicare Advantage market is on the rise, with a growth of 7.5% year-over-year, with more than 1.5 million new beneficiaries.

As technology availability and communication options increase, providers have ample opportunity to connect with their consumers in a way that works for all sides.

The Number: 3%

Submitted by Rob Wyse on Fri, 06/22/2018 - 14:59


Just 3 percent of Medicare beneficiaries represent 25 percent of Medicare expenditures.

According to a Bloomberg BNA report on June 18, even with this sizable share of funds, the three percent, made up of the advanced illness population, isn’t properly cared for by the current health care system. Now a proposal has been made for a new payment model just for this group with the most serious illnesses.

Alternative payment models were presented to HHS Secretary Alex Azar this month, who favored options serving those in various stages of serious illnesses, but ineligible or unwilling to enroll in hospice, according to Bloomberg BNA.

“The idea of these alternative payment models is to get away from Medicare’s strict reimbursement requirements and allow for a flexible payment structure; in this case to support the different types of services needed by very sick patients and their caregivers,” reported Mindy Yochelson for Bloomberg BNA.

No formal government announcement has been made yet, but the initial reaction to the plans have been very promising. “This is the strongest response from HHS yet to a proposal,” the co-chair of Coalition to Transform Advanced Care told Yochelson.