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The Value of Medicare Advantage

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

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The Value of Medicare Advantage

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  1. The Value of Medicare Advantage • Karen Ignagni • President and CEO • America’s Health Insurance Plans • July 16, 2007

  2. 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* Riskplans MedicareAdvantage Medicare +Choice BBA payment methodology and rural floors-PFFS option begins (-$97B) /10 years Part D 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) *Chart based upon CMS Medicare Advantage Fact Sheet (3/07).

  5. 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

  6. Congressional Intent Achieved MA Plans in 2003 MA Plans in 2006

  7. Medicare Advantage Payment-2007 Floor Counties

  8. Congressional Intent Achieved --Access to benefits and savings

  9. 53% Very Satisfied 37% Smwht Satisfied 49% Very Satisfied 35% Smwht Satisfied The overwhelming majority of seniors enrolled in Medicare Advantage plans are satisfied with their coverage, and satisfaction is up since 2003. 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)

  10. Serving Vulnerable Populations • MA is important choice for low-income and low-income minority beneficiaries

  11. 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. Source: Ayres, McHenry & Associates (March 2007) 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?

  12. MA Extra Benefits and Services -- Results

  13. MA and Medicare’s Financial Outlook: Long Term Costs

  14. Three-fourths of doctors think cuts to Medicare Advantage will harm seniors. Source: Ayres, McHenry & Associates (March 2007) 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?

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