MEDICARE+CHOICE: AAHP Decries ‘Fairness Gap’ in Payments
A new analysis released Friday by the American Association of Health Plans finds that if current trends continue, Medicare HMO reimbursements will be 16% to 30% lower than the payments for the fee-for-service program by 2004. According to the AAHP, this "fairness gap" was caused by the 1997 Balanced Budget Act. The report, prepared by PricewaterhouseCoopers, indicates that by 2004, 23.3% of beneficiaries will live in areas of the U.S. where the gap would be between $1,000 and $1,499, 15.1% will live in areas where the gap between Medicare HMO and fee-for-service payments would be between $1,500 and $1,999, and 12.1% would live in areas where the gap would be between $2,000 and $2,499. AAHP President Karen Ignagni said, "Unless the Medicare fairness gap is closed by Congress and the administration, beneficiaries in many parts of the country will not have access to Medicare+Choice plans" (AAHP release and study data, 2/26).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.