Medicare Advantage?Recheck your network

[ERhoosier]

United Healthcare is significantly cutting its provider network for Medicare Advantage in a number of states. Unclear just why these cuts are being made, although it appears it's not a quality move since Yale Medical Group is among those being dropped. During this open enrollment period, those on Medicare Advantage might want to check if your doc will remain in network for 2014.

UnitedHealthcare Cuts Doctors From Medicare Advantage Plans - Kaiser Health News

United Healthcare dropping many doctors from Medicare Advantage plan » Naples Daily News

http://www.medscape.com/viewarticle/813318

United Healthcare drops thousands of CT Medicare Advantage docs | HartfordBusiness.com

[donheff]

They are losing some or all of their subsidies under the ACA, aren't they?

[mf15]

Aetna cancelled my wife's whole plan, of which I say thanks.
Now she can get supplement plan F HD, guranteeded and no underwriting.
Old Mike

[ERhoosier]

Quote:

Originally Posted by donheff They are losing some or all of their subsidies under the ACA, aren't they?

Not sure the term "subsidies" is appropriate, but ACA did/does cut payments to Medicare providers by billions $$ in both Medicare Advantage and 'traditional' Medicare (p18 in this link).

http://www.cbo.gov/sites/default/fil...dreconprop.pdf

ACA also promised no change (or better) in Medicare benefits, but decreased payments. It appears the predicted decrease in choice of providers is coming to pass- at least for some.

[donheff]

Quote:

Originally Posted by ERhoosier Not sure the term "subsidies" is appropriate, but ACA did/does cut payments to Medicare providers by billions $$ in both Medicare Advantage and 'traditional' Medicare (p18 in this link).

IIRC Medicare Advantage programs got a 14% subsidy that was supposed to be transitional but didn't end. I think ACA finally cut it off. This is separate from the provider payment level.

[ERhoosier]

Quote:

Originally Posted by donheff IIRC Medicare Advantage programs got a 14% subsidy that was supposed to be transitional but didn't end. I think ACA finally cut it off. This is separate from the provider payment level.

Agree that MA changes with ACA are separate from provider payments.
According to this CMS report, through 2016 ACA is projected reduce "excessive MA payments" by $65 billion and "reform" (reduce) Medicare provider payments by another $85 billion.

https://www.cms.gov/apps/files/ACA-s...eport-2012.pdf

But higher Medicare Advantage insurance costs (8-13%) result not from a predetermined % "subsidy" but from a calculation of per capita (per Medicare recipient) carrier payments are based on certain regional benchmarks. The reasons for higher overall per-person costs of MA remain controversial (e.g. sicker population?, better care delivery?, overutilization of services?, waste?, etc.). Regardless, provisions of ACA are intended to reduce this higher cost of MA (vs traditional Medicare) as part of an effort to control overall Medicare spending.

http://www.medpac.gov/documents/MedP...sics_08_MA.pdf

Medicare Advantage: Facts, Fallacies, And The Future – Health Affairs Blog