Tag Archive for medicare

AHCA Makes Proposal to Reduce Medicare Spending

January 31, 2012 tarpey Insurance News

The nursing home industry is proposing its own ideas on ways to reduce uncontrolled Medicare spending in an effort to fend off significant Medicare cuts. The American Health Care Association is proposing that instead of taking a $2 billion hit, this money can be saved by ensuring that patients discharged from the hospital stay healthy.

In 2010, patients readmitted to a hospital within 30 days of discharge cost Medicare over $17 billion. The AHCA has consequently devised a plan that will provide incentives for hospitals to reduce the amount of readmissions. As a result, nursing providers will focus on providing top quality care and Medicare costs will decrease.  The AHCA Public Affairs Vice President Greg Crist was told that CMS officials were impressed that the sector was so willing to take such a bold initiative. Crist also hopes that the new proposal is favorably received by the Obama administration. The AHCA will also be urging the House Ways and Means Committee Chairman Dave Camp and the Senate Finance Committee to consider and ultimately accept this approach.

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HHS Selects 73 Advisors To Improve Healthcare

January 9, 2012 tarpey Insurance News

The Health and Human Services Department announced that 73 “innovation advisors” were selected to spend up to 10 hours per week working to change health systems in ways that will improve care. These advisors, made up of health care executives, academics, and other health care professionals, will work with the Center for Medicare and Medicaid Innovation to try to improve healthcare quality and lower costs.

Each advisor will be paid $20,000 to perform this task. During the first six months of the program, the 73 members will attend seminars and spend the remaining time testing new ways to implement their proposed changes.

These 73 people were selected from over 900 applications. What are your thoughts on this decision? Leave a comment below and let us know what you think!

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Medicare Premium Increase for 2012 is Surprisingly Small

November 3, 2011 tarpey Insurance News

The recent announcement about Medicare premium increases was met with positive and satisfied reactions. The increase was announced to be smaller than expected. Multiple news outlets reviewed the story and added their own opinions and perspectives on this developing story.

 

The New York Times clarified how the increase for monthly Medicare premiums for beneficiaries would only increase by $3.50, meaning they will pay $99.00 a month. From a political standpoint, the appraisal of the small increase by administration officials could help President Obama “as he tries to win the votes of older Americans in his bid for re-election.”

 

The Wall Street Journal makes a note of a remark made by Kathleen Sebelius, secretary of Health and Human Services. She said that the higher Social Security benefit, in combination with the smaller-than-expected Medicare premium increase, means the typical retiree could have about $40 more to spend each month.Also, while this new Medicare premium is an increase for about three-quarters of seniors and disabled people, “people who turned 65 in 2009, 2010 or 2011 have been paying $115.40 a month.” For those people, their premiums will decrease.

 

Sebelius also claimed that this lower-than-expected increase was “the latest round of good news” mostly due to the Affordable Care Act.

 

Most of those affected by Medicare were pleased by this small increase. It is allowing administrators to offer people better, more affordable Medicare.The Washington Post wrote that “The announcement was the third piece of good news about Medicare premiums this year.” AARP’s legislative policy director, David Lerner, stated, “This small increase is welcome news.”

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Recent Debt-Ceiling Agreement May Impact Medicare

August 3, 2011 tarpey Insurance News

According to a recent report from the Wall Street Journal, the recent debt ceiling agreement reached by Congress may impact older Americans reliant on Medicare or those with disabilities. Legislators may begin using means testing (in which wealthier people pay more for the program) and raising the eligibility age for Medicare.  Hospitals might even have to eliminate services due to a deal provision which would allow reimbursement cuts to clinicians treating Medicare patients. The deal also included a fall back spending-cut provision which includes Medicare cuts capped at 2%. While this directly impacts healthcare professionals, some medical groups say they cannot make these cuts without seriously affecting patients.

Washington wants more savings from medical providers, hospitals, and doctors in this debt deal that President Obama signed Tuesday (8/2/11). This deal is designed to protect seniors and others who rely on Medicare, but may in fact hurt those who need it most. If Congress cannot create a plan to reduce the deficit by $1.5 million dollars over the next ten years, the aforementioned debt ceiling plan will require a 2% across-the-board reduction in payments to Medicare providers beginning in 2013. Even though this Medicare cut is small, advocates for the elderly fear that this reduction could cause medical providers to reduce their services or stop serving them entirely.

 

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Limited “Doughnut Hole” Coverage Still An Issue

July 6, 2011 tarpey Insurance News

According to CNBC, “The federal health care overhaul delivers deep price cuts this year that will benefit Medicare prescription drug customers who fall into a coverage gap known as the ‘doughnut hole.’ But limited coverage still may pose a financial challenge for a few more years.”

For those unfamiliar, the term “doughnut hole” refers to the gap in Medicare prescription drug coverage that occurs when customers and their drug plans spend $2,840. After this point, the next $3,608 in costs must be picked up by the beneficiary. It is not until after this point that they become eligible for catastrophic coverage.

In order to compensate for the costs incurred due to the doughnut hole, $250 checks were given to those who fell into this coverage gap last year. This year, in order to further diminish the effects of this gap, “companies that make brand-name pharmaceuticals are providing 50-percent discounts, and plans that offer Medicare Part D prescription drug coverage will pick up 7 percent of the cost of generics.”

However, even with this effort to close the gap, there are still extra costs that remain. Part D beneficiaries can take steps to save even more money. For example, they can compile a list of the drugs their plan covers and ask their doctor if there are cheaper, non name brand alternatives.

It is predicted that the federal overhaul will close this gap by 2020. But until then, the doughnut hole will still exist to some extent.

Know of any strategies or steps that you have taken to help diminish the cost of prescription drugs? Share them in the comments below.

Still have questions? Feel free to contact the Tarpey Group.

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Aetna’s Medicare Marketing and Enrollment Suspension Lifted

June 28, 2011 tarpey Insurance News

In April of 2010, regulators suspended Aetna from marketing to and enrolling new beneficiaries into its Medicare Advantage (MA) and Prescription Drug plans. Medicare Advantage plans are privately run versions of the government’s Medicare program. These plans offer basic Medicare coverage with added extras or premiums lower than standard Medicare rates.

However, on Monday (6/13), Aetna Inc. reported that The Centers for Medicare & Medicaid Services (CMS) lifted this suspension. As a result, Aetna announced that it will immediately begin selling its MA and Medicare Part D Prescription Drug plans beginning on July 1st. The initial reason for this suspension was because the insurer changed its Part D plan from an “open formulary to a closed one, which involves payment tiers and in some cases, favors generic drugs over brand names.” CMS stated that Aetna did not transition some customers to the new payment tier correctly, which resulted in some subscribers being incorrectly denied medications.

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