More on Medicare Advantage
Following up, the Kaiser Family Foundation says the following about Medicare advantage costs:
Medicare Advantage plans are currently paid more, on average, than FFS costs in their area. According to MedPAC, payments to Medicare Advantage plans per enrollee in 2009 will average 114% of FFS costs for the counties where Medicare Advantage enrollees reside (Figure 3). (Emphasis added.)So, the numbers are not geographically cooked. It appears that the 14% number is an apples to apples comparison of geographically adjusted costs between traditional Medicare fee for service and Medicare Advantage Plans, on average.
If true, both Nancy upon the occasion of her enrollment and myself more recently were lied to by the Medicare Advantage representative who pitched us the plan. I will follow up and determine 1) what the true relationship was between the 2009 amount that was paid per MA enrollee and the 2007 average cost per Medicare participant and 2) what the true basis is for payment to the MA Plans per the 2003 establishing legislation. For clarification, what is the meaning of the acronym "FFS?"
ReplyDeleteFFS = Fee For Service, the payment basis for the traditional Medicare coverage plan. Medicare sets a payment amount for each covered service, and that's what the provider gets paid.
ReplyDeleteI suggest looking over the Kaiser Family Foundation report. It has a good summary of the Medicare Advantage "bidding" process and how private plans get qualified for the program.
Rereading the above, I am a little confused. Today is October 2, 2009. How can anyone know 1) what the amount paid per MA enrollee will average for the current year or 2) what the total FFS costs are(will be) per county for the current year.
ReplyDeleteThe Kaiser Family Foundation report sources the statement to Mthe edicare Payment Advisory Commission Report to Congress, March 2009.
ReplyDeletePresumably, they know what the payments will be to the Advantage Plans in 2009, as those are set in advance. As to the traditional Medicare costs, I would assume they are estimates based on the payment schedules and enrollment and usage data.