Managed Care

 

Medicare Advantage to remain robust this year

MANAGED CARE January 2013. © MediMedia USA
Managed Care Outlook

Medicare Advantage to remain robust this year

Not much will change in Medicare Advantage this year and that’s news, given some of the dire forecasts leveled about the program. “Despite reductions in payments enacted in the ACA [Affordable Care Act], and concerns about the effects of these reductions for plans and beneficiaries, the Medicare Advantage marketplace remains robust in 2013, with little change in the number of plans offered and relatively modest increases in average premiums,” says the report “Medicare Advantage 2013 Spotlight: Plan Availability and Premiums” from the Kaiser Family Foundation (http://tinyurl.com/Med-Advantage). “…On average, beneficiaries will be able to choose from among 20 plans, the same as in 2012. On average, beneficiaries will be able to choose from among 22 plans in urban areas and 13 plans in rural areas.... Almost all of the plans offered in 2012 will be available in 2013, so enrollees will be able to stay in the same plan if they choose.”

Special needs addressed

The number of special needs plans (SNPs) is expected to increase this year, the study says. “Of the 214 chronic care SNPs in 2013, 23 percent are focused on beneficiaries with diabetes, another 36 percent are focused on beneficiaries with diabetes and some form of cardiovascular disease and/or congestive heart failure, and 27 percent are focused on beneficiaries with specific lung conditions.”

However, the number of SNPs specifically for persons with dual eligibility will decrease. “Interpreting the change is complicated by the fact that states have been pursuing pilot demonstrations in 2012 to better align Medicare and Medicaid spending for dual eligibles.”

Number of MA plans by plan type

Medicare beneficiaries with access to one or more MA plans in 2013

Distribution of SNPs by plan type

Source: “Medicare Advantage 2013 Spotlight: Plan Availability and Premiums,” Kaiser Family Foundation, December 2012

Meetings

Private Health Insurance Exchanges Conference Washington, D.C. October 7–8, 2014
National Healthcare Facility Management Summit Palm Beach, FL October 16–17, 2014
National Healthcare CFO Summit Las Vegas, NV October 19–21, 2014
National Healthcare CXO Summit Las Vegas, NV October 19–21, 2014
Innovative Member Engagement Operations For Health Plans Las Vegas, NV October 20–21, 2014
4th Partnering With ACOs Summit Los Angeles, CA October 27–28, 2014
2014 Annual HEDIS® and Star Ratings Symposium Nashville, TN November 3–4, 2014
PCMH & Shared Savings ACO Leadership Summit Nashville, TN November 3–4, 2014
World Orphan Drug Congress Europe 2014 Brussels, Belgium November 12–14, 2014
Medicare Risk Adjustment, Revenue Management, & Star Ratings Fort Lauderdale, FL November 12–14, 2014
Healthcare Chief Medical Officer Forum Alexandria, VA November 13–14, 2014
Home Care Leadership Summit Atlanta, GA November 17–18, 2014