Medicare advantage by the numbers
Friday Pulse Check
Good morning and happy Friday. Welcome to the Friday Pulse Check. In a minute, I’ll be taking a look at Medicare Advantage by the numbers. The Better Medicare Alliance released its annual report and it shows the program is growing significantly.
But first the news:
60% of Americans researching healthcare prices looked at their insurance carrier
At first glance, this may seem like a shocking finding, but if you think back to a podcast Ron and I did about a month ago, hospitals already aren’t following through on a Federal law requiring them to publish their prices. That being said, it also makes sense that those researching healthcare prices are going to look to their insurance carrier because that is who is going to determine how much they pay. On the one hand, this could really help patients save some money. On the other hand, as we also discussed back in February, insurance carriers can be sneaky about how they market different doctors. UnitedHealthcare (UNH 0.00) at one point tried to say certain radiologists were “better” providers because of some quality metrics that didn’t mean anything. What it really boiled down to was it saved UHC some money. The YouGov/AKASA also found that only 36% of Americans actually researched healthcare costs before going to see a doctor. The key takeaway: Americans do care about the rising costs of their care and if their provider won’t tell them the price, they’ll turn to someone who will. Read more from CISION PR Newswire.
The Colorado Option
Congress is not going to move forward on Medicare for All any time soon and despite the fact that the public option is a bit more palatable to Americans, that isn’t coming from the Federal government either. So states have taken the initiative on their own and Colorado seems to be at the front of the pack. Both payors and providers are not fans of the public option in general. The payors fear it because they would have to compete against a government-run or backed plan and the providers don’t like that it would force down their reimbursement. Being provider advocates, we are more concerned with the latter. Colorado’s public option is requiring insurance carriers to create a Colorado option and sell it to individuals and small businesses, they must cap premiums (they must be 5% lower in 2023 than they were in 2021 for any particular county, then adjusted for inflation), and they must have an expansive network. If the carriers can’t do any of this, the state will get involved and compel (force) providers and hospitals to accept lower rates and join the network. Needless to say, this is a bad idea. We will likely have more analysis on this next week on the FLATLINING Podcast. Read more from the Dispatch.
Pulse check on the election
I ran the FLATLINING Podcast solo this week and on this short, provided some analysis on the 2022 midterms. To sum it up, at your state and local levels, expect to hear a lot about COVID-19 restrictions. To those of you thinking, “we’re way past that now,” I agree, but if the last Republican gubernatorial debate in Michigan which aired on Wednesday night is any indicator, that is what local Republicans are fired up about. Remember, people have long memories of their local community. As I said on Wednesday, Republicans think that if they can remind you about all the bad things your Democratic governor did during COVID lockdowns, they might be able to change minds they couldn’t change before.
On the Federal level, we will see a lot more discussion around affordable healthcare and drug pricing from the Democrats. President Biden ran on the public options (see how that is working out above) and negotiating costs with the drug manufacturers. With the Senate split down the middle, neither of these things are going to happen this year. So, as Democrats rally their base they’re going to try to make the case to go out and vote so these things can get done. On the other hand, super-progressives might be frustrated with the fact so little got done in a situation where Democrats control the house and Vice President Kamala Harris can cast a tie-breaking vote in the Senate.
For the Republicans at the federal level…. I don’t expect much if anything related to healthcare.
Medicare advantage by the numbers
This week, the Better Medicare Alliance released its 2022 “State of Medicare Advantage Report.” The report, released annually, compiles research and data from the Medicare Advantage (MA) program and provides insight into demographics, enrollment trends, and health outcomes. Here are some of its findings.
The MA enrollment is 28.4 million which accounts for about 45% of the total Medicare population. This is nearly double what the enrollment was 10 years ago and projections suggest MA enrollees will account for half of the Medicare program by 2026.
Currently, there are 3,843 MA plans being offered to eligible patients; this is an 8% increase from 2021. Over 90% of the plans offer dental, vision, and hearing coverage. 89% of the plans offer prescription drug coverage and almost all of them offer supplemental benefits. Of the 28.4 million members, 60% are enrolled in an HMO plan and 36% are enrolled in a PPO plan.
More than 52% of MA enrollees have an annual income of less than $25,000, but on average, MA members spend $1,965 less on out-of-pocket costs and premiums compared to Medicare members.
34% of MA members identify as racial and ethnic minorities. Compare this to the 16% of Medicare members who do so.
So there are some demographic numbers for you. How about the health outcomes?
During the COVID-19 pandemic, MA members were hospitalized 19% less for COVID-19 than Medicare members.
Among other diseases, over 37% have diabetes, almost 20% have obstructive pulmonary disease, over 7% have congestive heart failure, and over 4% have been diagnosed with dementia or Alzheimer’s.
I figured I’d save the most feel-good news for last. Finally, starting at a fifteen-year low, the average Medicare Advantage monthly premium is $19 and 94% of members are satisfied with their coverage.
In a weird bit of Ukrainian health news this week, Russian hackers are apparently to blame for fake radio broadcasts, claiming that Ukrainian President Volodymyr Zelenskiy had been admitted to an ICU and was giving presidential duties to Ruslan Stefanchuk, Chairman of the Ukrainian parliament.
Mr. Zelenskiy posted a video of himself in his office to his Instagram, yesterday, assuring Ukrainians and the world that his in good health.
Now, I do not know how the transfer of power is supposed to work in Ukraine if this situation were to occur. If someone else has the time and interest to find out, I’d love to hear from you.
That does it for this edition of the Friday Pulse Check. Have a good weekend,
Editors note: A previous version of this article said the average premium for Medicare Advantage plans was $15. This was incorrect and has been corrected above.