Well, that’s the question. do Medicare Advantage Plans 2020 work? Well, some people say they do and some say they don’t.
A recent study by researchers at Michigan State University discovered that Medicare Advantage Plans are not really superior to standard managed care plans in terms of quality of care. The study was done on participants of an insurance pool which were older individuals. These individuals were eligible for both Medicare and Medicaid.
It was found that their quality of care was “fair” and that they received excellent care from the physicians who worked for both organizations. The authors of the study concluded that the researchers’ findings support the principle that consumers receiving traditional fee-for-service health care services from physician groups have a greater expectation of quality of care than those receiving services through Medicare Advantage Plans. There is not a “silver bullet” solution to the problem of high health care costs, but the researchers did provide one very valuable advice: Providers of high quality care should be paid more for the same or better care and that pay ratio should be improved through the provision of incentives.
Although the original study was very good and it has received a lot of attention, it’s now under fire for what some critics believe is a series of omissions. A new report by the GAO found that the program had all kinds of problems, including, but not limited to, under-reporting of data, improper claims, insufficient payment for care and too many claims. This was an even bigger problem in the case of the planned enrollment period.
It is my opinion that the study found by the GAO provides not only a solid confirmation of the work of the researchers, but also a validation of the findings of an earlier, independent study. If Medicare Advantage Plans work, it’s because of the payment incentives and cost controls the plans put in place. The new GAO report only confirms what I have said previously. The most likely programmatic results are that the program will continue to expand without being replaced with something different. It would seem that the findings of the GAO study cannot be altered in any way without the companies doing a complete reversal of their previously announced plans for expansion.
People who are still convinced that these plans are the answer to the program’s problems need to re-examine their beliefs. More people are turning to managed care plans when they can’t get to the doctors they need. Physicians are finding that they are not only paid more but also can claim higher reimbursement rates. That’s the best news there is.
It appears that the study by the GAO did not find everything wrong with the program, but rather validated a report that some on the outside are already arguing was flawed. Many who had issues with the program have now been shown the light.
Now, many of those who had issues with the program are claiming that they now support the program in spite of the problems the program has encountered in the past. A new program that treats its members fairly, treats them with respect and treats them well has to be the ideal situation.
But no one can doubt that the best thing would be for McCain to take a hard look at this issue and come up with some plans of his own. After all, the Republican Party platform calls for a phased transition to a system that works and if McCain is ever going to win the nomination again, he needs to show some initiative.
Then again, the growing number of people with Medicare Advantage Plans could also mean that we will soon be on the brink of another health care crisis. And the fact that President Obama has only recently started talking about a Medicare buy in plan is also troubling. You would think the president would already have a solid plan in place to keep this coming.
The bottom line is that the success of Medicare Advantage Plans 2020 will be determined by the ongoing success of the program, as well as the failure of President Obama to make plans that are better than the status quo. So far, the programs seem to be running on autopilot.