Medicare+Choice Reimbursement Rates Increased, Impact in Fresno Remains Unclear
Although Medicare+Choice plans in Fresno County will receive a 20% increase in reimbursement rates this year, it remains uncertain if the increased payments will keep health plans from exiting the market or "lure back" those that have already left the Valley, the Fresno Bee reports. Set to take effect March 1, the increased reimbursements also will raise payments in Tulare County by 16%, in Madera County by about 11% and in Kings County by almost 3%. Over the past year, Blue Cross of California and Health Net announced plans to exit the Medicare+Choice market, leaving about 3,000 Valley seniors looking for new insurers. In addition, providers that remained in the market raised premiums or reduced the benefits they offer. Despite the increased reimbursements, Blue Cross still plans to cancel its Medicare+Choice programs in Fresno and Madera counties. Blue Cross spokesperson Lisa Mee-Stephenson said, "We are evaluating all the federal increases. It is unlikely we would re-enter the Fresno market." PacifiCare, which froze enrollment in the Fresno-Madera market and raised premiums, called the reimbursement increase "a step in the right direction." PacifiCare spokesperson Tyler Mason said that he was unsure if PacifiCare would end its enrollment freeze. Only two companies, Pacificare and Kaiser Permanente, remain in the Medicare+Choice program in Fresno County, and only Kaiser offers prescription drug coverage (Correa, Fresno Bee, 1/16).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.