WASHINGTON – The Obama administration estimates that making private payers with Medicare Advantage (MA) plans compete for services will generate $177 billion over 10 years – an amount that will help fund healthcare reforms.
The payer community is both defending their plans and evaluating business strategies as the Centers for Medicare and Medicaid Services gathers public comments prior to the April 6 release date of its final rate notice for MA plans.
The cost savings expected to come from these plans will only account for 30 percent of funds to pay for healthcare reform, said Robert Zirkelbach, spokesman for America’s Health Insurance Plans. More importantly, he said, reform should not come at the expense of the almost 11 million seniors enrolled in MA plans.
“Aetna has been very careful” with its involvement in Medicare programs, said Mohit Ghose, vice president of public affairs for the insurer. Whatever the outcome, he said Aetna will be “well prepared” for healthcare reform with its diversified set of products.
BlueCross BlueShield of Tennessee’s MedAv plans service a “growing number of Tennesseans,” said Rob Slattery, vice president of BlueCross’ senior care division for BCBST.
While BlueCross is evaluating the new rate proposal to determine its potential impact, Slattery said, “We are concerned that the proposed 2010 rates may lead to fewer choices for beneficiaries or put pressure on prices next year.”
William Krenz, executive vice president of Medicare Advantage operations for Universal American Insurance, said Universal’s MA plans are well managed, focused on wellness and include additional benefits that are “well appreciated and used” by its members. Krenz said Universal is “well positioned” to weather the anticipated 5 percent reimbursement reduction for 2010 because “we take care of our beneficiaries with richer benefits controlled through the network.”
“WellPoint believes Medicare Advantage is an important option for seniors that provides additional choice and high-quality, high-value care,” said Cheryl Leamon, a spokesperson for WellPoint, which has nearly 449,000 members in its MA plans.
She pointed out that for a premium payment, private insurers are required to provide additional benefits, coordinated care and disease management programs that traditional Medicare plans don’t offer. Any reimbursement cuts, therefore, would reduce those benefits, she said.
To prepare for CMS’ final publication, WellPoint is reviewing its premium structures and plan designs, Leamon said.