Listen now (36 mins) | A new model rolling out is drawing fire - and you could be enrolled in it, whether you like it or not.
Mark Miller sounds like you are throwing Medicare Advantage plans under the bus if people are older or sick? Versus what? Original Medicare has no cost containment - you are on the hook for 20% of the bill. Medicare Advantage plans have MOOP - maximum out of pocket - which protects someone from sky high bills by capping the annual maximum out of pocket. MedSup plans are great, but they go up every year and get very pricey when someone is 80 or 90 years old. If they get really sick their costs are covered, but they also paid in potentially a lot of money over the years when they were healthy.
So...what can WE, the people do about it? Probably nothing! Not right to be able to change Traditional Medicare but they'll do whatever they want to do and we'll HAVE TO GO ALONG WITH IT!!
presume some analysis has been performed on where each health care $$ ends up in the US, and which of those $$ do not directly contribute to quality health care outcomes. How does this change redirect $$ flows away from activities that do not directly contribute to quality outcomes? I am deeply concerned with private equity’s interest, since lip service aside, they have zero interest in improving patient health care access. Steps that make health care delivery unattractive to private equity should be considered, maybe including a reimbursement schedule that makes reimbursement amounts inversely proportional to provider size.
I am wondering if this is why there has suddenly been so much advertising in the SF Bay Area from One Medical encouraging those on Medicare to join their plan. Are they a DCE or ACO?