Christian Science Monitor Examines Medicare+Choice Enrollment Effort
The Christian Science Monitor today reports on efforts to attract managed care organizations back to the Medicare+Choice program and to increase the number of beneficiaries enrolled in managed care. After providing a background on Medicare and the advent of the Medicare+Choice program, the Monitor reports on how health plans began increasing prices or dropping benefits after Congress reduced payments to MCOs in 1997. With costs increasing faster than revenues, many plans have exited the program, and more than 1.6 million beneficiaries have consequently returned to traditional fee-for-service Medicare over the past three years. Now, the Monitor reports, HCFA Administrator Thomas Scully wants to increase Medicare+Choice participation from the current 14% of Medicare beneficiaries to 30%. To increase participation, Congress must produce "stability" in the program, which former HCFA head Bruce Vladek says means raising reimbursement rates for MCOs.
While Congress last year appropriated additional funds for Medicare MCOs as part of the Benefits Improvement Act, a larger Medicare "giveback" package, lawmakers are "unlikely" to appropriate another "broad-based increase" this year. Congress may increase payments for Medicare HMOs in rural areas, where a "large percentage" of pullouts have occurred. But developing a provider network in such areas is "difficult," and many analysts "doubt that HMOs can be viable there." The Monitor reports that one "easy step" Scully can take is to reduce the paperwork requirements placed on Medicare HMOs. Grace-Marie Hunter, president of the Galen Institute, a research organization, said, "Regulations and paperwork cost money. There's no bureaucracy like the federal government." Former HCFA administrator Gail Wilensky said that reducing paperwork would also indicate to beneficiaries that the government is working to make the plans "more attractive." She added, "If people believe there are more [MCO] plans available, they will choose them" (Hey, Christian Science Monitor, 6/14).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.