Managing Medicare » General

CMS Releases Proposed Changes to MA and MAPD Programs for CY 2012

jbaker — Sat, 13 Nov 2010 00:58:37 +0000

CMS on November 10, 2010 release the proposed changes to the MA and MAPD program for CY 2012. The proposed rule changes will is expected to be published in the federal register on November 22, 2010. A headline summary of changes is as follows:

Implementing provisions of the Affordable Care Act;
Clarifying various program participation requirements;
Strengthening beneficiary protections;
Strengthening Medicare’s ability to distinguish stronger health plans for participation in Medicare Parts C and D and to remove consistently poor performers; and
Implementing other clarifications and technical changes.

One of the most notable changes is to the rule governing the 2012 Medicare Advantage Quality Bonus Payment Demonstration program. The current ACA legislation only provides bonus to plans who receive an overall rating score of 4 or 5 stars (The average of the Part C and D scores). Leaving no bonus to plans who score a 1,2, or 3 rating (See chart).

The rule change is intended to test if providing additional bounce opportunities at the 3 and 3.5 star level accelerate the progression of improvement of plans to higher STAR rating levels. The demonstration program will run for 3 years from CY 2012 through 2014.

Based on the 2011 Star ratings, this change in bonus methodology significantly changes the number of plans who qualify for a bonus. Under the original rules only 16 plans would have received a bonus. Under the demo rules an additional 39 plans will receive a bonus totaling 55 plans.

Medicare and You Handbook – 2011

jbaker — Wed, 27 Oct 2010 14:39:44 +0000

There seems to be quite a bit of interest as to where you can find a copy of the 2011 Medicare and You Handbook. There are two ways you can get a copy

1) Call Medicare to request a copy: 1‑800‑MEDICARE (1‑800‑633‑4227)

2) Download a copy at the following link: http://www.medicare.gov/publications/pubs/pdf/10050.pdf

Happy 2011 Annual Enrollment Period!

HHS Awards $130M Grant to Strengthen the Healthcare Workforce

jbaker — Tue, 21 Sep 2010 19:03:03 +0000

Today Kathleen Sebeluis announced a $130.8 million in grants to strengthen and expand the health professions workforce. Here is the breakdown.

Training:

Primary Care – $42.1 million
Oral Health – $23.9 million

Equipment:

$50.5 million for e-learning tools

Assistance:

Loan repayment – $8.3 million
Opportunity program – $2.1 million
Patient Navigator – $ 3.8 million

Free Webcast of UCI “Health Care Reform in an Election Year”

jbaker — Tue, 07 Sep 2010 15:14:01 +0000

I attended this event in February. I really appreciated the cross functional perspectives from various providers and payers on the direction of the heal care and their response to the new legislation. I would recommend reviewing this as a webcast.

—————-From Margaret Wong——————–

The Center for Health Care Management and Policy
is pleased to present the taped webcast of the

2010 Health Care Forecast Conference
“Health Care Reform in an Election Year”

Held on February 25-26, 2010 in Irvine, California
Keynote Speaker: Norman J. Ornstein, PhD, Resident Scholar, American Enterprise Institute

Conference sessions are as follows:

Forecasts: U.S. Economy, Private Sector Health Care, Federal Health Care Expenditures, Medicare & Medicaid
Health Care Reform – What Next?
Conference Keynote Address: Health Politics and Policies in an Election Year
Impact of Health Care Reform on Major Stakeholders
Innovations in Reducing Cost and Improving Quality of Health Care
Strategic Outlook on the Health Care Market

To view the conference speakers and powerpoint presentations, please visit
merage.uci.edu/go/hccvideo

2011 “Medicare & You” Handbook – Plan Data Preview

jbaker — Fri, 20 Aug 2010 16:25:35 +0000

FROM HPMS Memo Dated August 20, 2010:

As in past years, CMS is offering your organization an opportunity to preview how your plan data will appear in the upcoming “Medicare & You” handbook. This year, the preview period will be Friday, September 3 through Wednesday, September 8. Specific times will be provided in future notices. Please note that the Labor Day holiday falls within this preview period, as it did last year, so please plan accordingly. Please review your data as early as possible during the preview period to ensure these updates are reflected in a timely manner in the various materials and tools available to Medicare beneficiaries.

It is critical that you preview your data for accuracy. This data will appear in the following places:

The “Medicare & You” handbook
Numerous letters and notices mailed to LIS-eligible beneficiaries
A variety of other materials and resources

Medicare Trustees Report – No One Agrees, Still

jbaker — Fri, 06 Aug 2010 17:31:40 +0000

Thursday’s release of a report authored by the trustees charged with gauging the solvency of Social Security and Medicare each year shows that Medicare’s hospital trust fund will remain solvent until 2029, 12 years longer than projections before health reform. That is the good news that Democrats are referencing given this is the first report since the enactment of Health Reform legislation.

However there are provisions that seem to contradict each other. The models project a $575 billion savings from Medicare over a 10 year period. The confusion lies with how the savings are applied. The report shows that the dollars saved are used to both expand coverage to the uninsured AND extend the life of the trust fund.

Here lies the problem with trying to determine if Health Reform works, is financial sound, or has a future.