Medicare+Choice Fails to Increase Options, Study Says
The Medicare+Choice program, having failed to meet lawmakers' goal of expanding choices available to Medicare beneficiaries, has earned a grade of "'D' if not an 'F'" according to a new report released in the July/August issue of Health Affairs (Gold, "Medicare+Choice: An Interim Report Card," July/August 2001). Seniors who turned to Medicare managed care programs for benefits not found in traditional Medicare, such as prescription drug coverage, "are instead getting dropped" as insurers leave Medicare+Choice, the AP/Las Vegas Sun reports. Marsha Gold, a senior researcher with Mathematica Policy Research and author of the study, said, "Everyone's been disappointed," adding, "There's no easy solution." The study was based on an analysis of plan benefits, patient enrollment and various data about Medicare+Choice (AP/Las Vegas Sun, 7/9). According to the report, in contrast to the stated goals of Medicare+Choice upon its inception in 1997, the program has actually led to "diminished" choice for Medicare beneficiaries. In 1999, 97 plans either withdrew from the market or "reduced their service areas," affecting 407,000 beneficiaries. In 2000, 99 plans withdrew, affecting 327,000 beneficiaries, and in 2001, 934,000 beneficiaries were affected by withdrawals or service reductions. In addition, Medicare+Choice did not lead to increased competition in rural areas, where previously "little or no choice" existed, and the "inequities in benefits and offerings between higher- and lower-paid areas of the country have widened rather than narrowed."
According to the study, "experience suggests" that Congress will likely have to raise payments to health plans "substantially" for Medicare+Choice to have any "chance of succeeding." The report states, "From a purely technical perspective, Congress may find much more efficient ways to improve care in rural areas or provide prescription drug benefits to all Medicare beneficiaries." Still, the report says that in the debate over large-scale Medicare reform, Medicare+Choice "can be viewed as a compromise" between those who favor a market-based approach and those who favor the current government-backed model of Medicare. But if Medicare+Choice is to succeed, the traditional Medicare program has to become "much less attractive," to beneficiaries, a difficult prospect as "Congress generally still does not favor strong steps that might jeopardize" traditional Medicare. The study suggests that "Congress is unlikely to succeed in addressing many issues plaguing the Medicare+Choice program until it comes to terms with fundamental differences in ideology, values and the vision for Medicare's future" ("Medicare+Choice: An Interim Report Card," Health Affairs July/August 2001). The full study can be found at http://dandini.catchword.com/vl=981079/cl=21/nw=1/fm=docpdf/rpsv/catchword/phope/02782715/v20n4/s14/p120. Note: You will need Adobe Acrobat Reader to view the study.