Tuesday, April 2, 2024

Never enroll in a Medicare Advantage plan (it is a hazard to your health)

 AI used by brokers to pick plans to sell:

https://generations.asaging.org/medicare-decisions-should-not-be-left-ai

Prior Authorization prevents you from getting the health care you need:

https://ldi.upenn.edu/our-work/research-updates/the-billing-bottleneck-how-medicare-advantage-insurers-use-prior-authorization/

MA patients have lower rate of hospitalizations, and that might not be a good thing:

https://www.fiercehealthcare.com/payers/study-details-why-medicare-advantage-avoidable-hospitalizations-lower-compared-traditional


Humana decided there's more money to make in selling Medicare Advantage that selling Employer Group Health Plans:

fiercehealthcare.com/payers/humana-shed-employer-group-commercial-business

Surprise Billing:

https://www.fiercehealthcare.com/payers/cms-astronomical-volume-surprise-billing-dispute-cases-taking-toll-agency


Kaiser discussion on 2023 Medicare Advantage payments

One of the speakers, Tom Kornfield, spent 10 years at CMS before he went into the private sector.  He has a vested interest in disparaging the payment changes the federal government is trying to make to MA plans.  I point this out because this CMS changes affect his clients and thereby, indirectly affects the consulting fees his firm will get. I find it hard to believe his spin because of it. This is his background: Tom also spent 10 years working at the Centers for Medicare & Medicaid Services (CMS), where he held a variety of positions focused on MA and Part D payment policy. Specifically, Tom analyzed MA bids and payments and changes in MA payment rates, and he created a policy to allow for 5-star MA plans to market and enroll year-round. 

https://www.kff.org/medicare/event/march-21-web-event-unpacking-the-controversy-over-medicare-advantage/

Action Now Initiative March 3, 2023 letter to CMS captures why CMS needs to rein in the excesses of Medicare Advantage Billing:

https://www.arnoldventures.org/stories/whats-going-on-with-medicare-advantage-arnold-ventures-experts-explain

Analysis of how MA plans are sucking money out of Medicare.  It is soooo complicated.  Why won't the federal government stop the shenanigans?

https://www.healthaffairs.org/content/forefront/born-third-base-medicare-advantage-thrives-subsidies-not-better-care

Sunday, March 31, 2024

Never enroll in a Medicare Advantage Plan (because they overbill the government)

 This is great analysis about the insurance industry siphoning off  Medicare funds (aka your tax dollars) and destroying Medicare:

https://www.morningstar.com/news/marketwatch/2024032679/medicare-advantage-is-overbilling-medicare-by-22

Wednesday, March 20, 2024

Never enroll in a Medicare Advantage Plan (ever)

 The interview in "MedPage Today" is great.  It is with a former CMS Administrator who was a doctor.  There are now many, many news reports about the problems with Medicare Advantage insurance. It is a wonder they are still legal!  Just search Medicare Advantage in the "News" category of your search engine and you'll see them.  Some legislators, like Elizabeth Warren, are trying to sound the alarm. 

https://www.medpagetoday.com/special-reports/exclusives/108980