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Medicare Supplement Market Premium Grows 5.4% to $27.1 Billion

Posted by www.psmbrokerage.com Admin on Tue, Apr 26, 2016 @ 08:25 AM


CSG Actuarial has compiled information from the NAIC and other sources, and is reporting total earned premiums in the Medicare Supplement market in 2015 totaled $27.1 billion, a 5.4% increase over 2014.

A few other notes of interest:

The total Medicare Supplement lives covered in 2015 increased to almost 12.3 million, up 6.1% from 2014.



The top 10 carriers in terms of 2015 Medicare Supplement premiums were:

1.United Healthcare 2.Mutual of Omaha 3.Anthem 4.HCSC 5.Aetna 6.CNO Financial

7.BCBS of MA 8.Cigna 9.Wellmark 10.BCBS of FL

As shown below, the percentage of Medicare Supplement policyholders with Plans G and N continued to increase in 2015.


Source: https://www.csgactuarial.com/2016/04/medicare-supplement-market-premium-grows-5-4-to-27-1-billion

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Tags: Medicare, Medicare Supplement, Cigna Medicare Supplement, Mutual of Omaha Medicare Supplement, UnitedHealthcare Medicare Supplement

Salespeople vs. the Internet: Who Is Winning?

Posted by www.psmbrokerage.com Admin on Tue, Apr 19, 2016 @ 03:48 PM


When the Internet exploded onto the scene in the late 20th century, we heard confident predictions from many experts that sales forces would soon become extinct. Buyers would no longer need (nor want) salespeople to educate and inform them — the Internet would perform these functions instead. And smart executives would not continue to employ these expensive order takers — online order forms would do that job just fine.

I guess those arguments made sense at the time, because other roles inside the corporation had already been automated or eliminated by technology. Factory workers, switchboard operators, bookkeepers, administrative pools — they’d all been replaced to some degree by automation. So it seemed completely reasonable that sales forces, too, would meet such a fate. Cost-cutting and headcount reductions would surely reach the sales team. It was just a matter of time.

Well, unfortunately for the doomsday prognosticators that hasn’t actually happened.

I was recently doing some research with the Sales Education Foundation, and I came across some interesting statistics. According to the U.S. Bureau of Labor Statistics, in 1999 there were 12,938,130 workers in sales and sales-related occupations the United States. Impressively, that number represented 10.2% of the total employed workforce.

In May of 2014 (the most recent data available), the BLS asserted that there were 14,248,470 such workers employed in the U.S. or 1,310,340 more than there were 15 years earlier. This total now accounts for 10.5% of the U.S. employed — a slight increase from 1999. Not only does the data not support a doomsday scenario for sales forces, salespeople are in fact holding their own in the workforce. So why has the Internet not replaced our salespeople?


“Rather than reduce the power of salespeople,
(the Internet) has made salespeople more powerful
than before.”

Jason Jordan | Partner, Vantage Point Performance


Because the Internet never became a foe of the sales force. Ironically, it became one of the sales force’s dearest friends. Rather than reduce the power of salespeople, it made salespeople more powerful than before. Internet-enabled CRM allowed salespeople to sell more efficiently and effectively anywhere in the world. LinkedIn, Twitter, and other social networks gave sellers unprecedented insights about their customers and prospects. The Internet created an entire industry of sales enablement tools that never existed before. In the end, the Internet stood with the sales force, not against it.

But more fundamentally, the doomsday criers dramatically underestimated the resilience of the sales force. I would argue that sales is the most in-tune and dynamic function inside any company. It feels shifts in the landscape before other parts of the organization, and it reacts to the marketplace the best. It has the strongest motive to succeed, and it adapts to change the fastest. In retrospect, it was a little naive to think sales forces would battle technology rather than embrace it. Sales forces welcomed the Internet with open arms.

The Internet has changed our world more than other any other technology in the 21st century; however, it doesn’t look like it will replace our salespeople. Companies still need them, and customers still want them. It turns out that sales forces are more than just walking, talking brochures and order forms — they add a lot of value. So how will the relationship between the Internet and the sales force evolve over the next 15 years?  I’m not sure, but I bet it makes our sales forces even better than they are now.

Source: https://www.salesforce.com/quotable/articles/salespeople-versus-the-internet

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Tags: sales, internet sales

Federal Regulators Release Medicare Advantage Payment Increase for 2017

Posted by www.psmbrokerage.com Admin on Tue, Apr 12, 2016 @ 03:39 PM


On April 4, the Centers for Medicare and Medicaid Services (CMS) released the final updates to the Medicare Advantage and Part D programs for 2017.  An article from Bloomberg on the same day summarizes the impacts of the increase across the industry.

The U.S. is raising payments to the insurers by 0.85 percent on average, according to a statement Monday from the Centers for Medicare and Medicaid Services, down from the 1.35 percent boost proposed in February. Payments to individual insurers can vary, because CMS gives individual plans quality bonuses and premiums are adjusted based on where enrollees live and how sick they are.

 The smaller increase gives less of an increase to top providers of Medicare Advantage plans such as UnitedHealth Group Inc. and Humana Inc. Other publicly traded insurers that are big providers of the private Medicare plans include Aetna Inc., Centene Corp., and WellCare Health Plans Inc. The U.S. raised rates by about 1.25 percent for this year, after a cut of about 4 percent in 2015. Medicare Advantage plans are run by private health insurers, and funded and regulated by the government.

Click here to read the Bloomberg article.

Click here to read the full release from CMS.

Source: https://www.csgactuarial.com/2016/04/federal-regulators-release-medicare-advantage-payment-increase-for-2017/

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Tags: Medicare Advantage, Medicare Advantage News, CMS

Spring Is the Season of Opportunity—Don’t Waste It

Posted by www.psmbrokerage.com Admin on Fri, Apr 01, 2016 @ 09:56 AM


Everyone has to get good at one of two things: planting in the spring or begging in the fall.

I know the following things to be true: Life is about constant, predictable patterns of change. The only constant factor is our feelings and attitudes toward life. We have the power of attitude, and attitude determines choice, and choice determines results. You cannot change the seasons, but you can change yourself.

I am convinced that, as human beings, it is our natural destiny to grow, to succeed, to prosper and to find happiness while we are here. That we must make a constant and conscious effort to improve ourselves in the face of changing circumstances.

Let’s talk about spring. Spring is the season of activity and opportunity that follows the turbulence of winter. It’s the season for entering the fertile fields of life with seed, knowledge, commitment and a determined effort.

However, the mere arrival of spring is no sign that things are going to look good in the fall. You must do something with the spring. Everyone has to get good at one of two things: planting in the spring or begging in the fall. Take advantage of the day and the opportunities that spring can bring.

It is the promise of spring that as we sow, so shall we also reap. For every disciplined human effort, we will receive a multiple reward. For each cup planted, a bushel reaped. For every good idea given to another, many shall be given to us in return. For every act of love given, a life of love in return.

Just remember, it is a natural characteristic of springtime to present itself ever so briefly, or to lull us into inactivity with its bounteous beauty. Do not pause too long to soak in the aroma of the blossoming flowers, lest you awaken to find springtime gone with your seed still in your sack.

With the intelligence, wisdom and freedom of choice given to us as humans, exercise the discipline to plant in spite of the rocks, weeds or other obstacles before you. The rocks, weeds and thorns of the world cannot destroy all your seeds if you plant massively enough and intelligently enough.

Choose action, not rest. Choose truth, not fantasy. Choose a smile, not a frown. Choose love, not animosity. Choose the good in life in all things, and choose the opportunity as well as the chance to work when springtime smiles on your life.

Spring shows us that life is truly a constant beginning, a constant opportunity and a constant springtime. We need only to learn to look once again at life as we did as children, letting fascination and curiosity give us welcome cause to look for the miraculous hidden among the common.

Get busy quickly on your springs—your opportunities. There are just a handful of springs that have been handed to each of us. Life is brief, even at its longest. Whatever you are going to do with your life, get at it. Don’t just let the seasons pass by.

"Indecision is the thief of opportunity" - Jim Rohn

Source: http://www.success.com/article/rohn-spring-is-the-season-of-opportunity-dont-waste-it

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Tags: prospecting, motivation

Stop Trying to Motivate People - It Won’t Work

Posted by www.psmbrokerage.com Admin on Mon, Mar 28, 2016 @ 08:52 AM


Stop Trying to Motivate People—It Won’t Work

Instead, find out what drives their behavior and tap into their personal motivators. Here’s how.

We all want to motivate someone. Parents struggle to motivate their kids. Wives try to motivate their husbands, and vice versa. And organizations attempt all the time to come up with something that will motivate their employees, from giving out company coffee mugs to bonuses.

But you can’t motivate another person.

Why? Because different people have different motivators. One person might be motivated most by the opportunity to contribute while a co-worker is motivated by the freedom to choose how to contribute.

What you can do, and what will bring lasting results, is figure out what already motivates a person and tap into that. But managers don’t often do this.

I once worked for a fancy resort and country club. Every time I would do something really well, my boss would give me a sleeve of very expensive golf balls. Guess what she forgot to ask me? “Do you play golf?”

One time I approached her and told her the CEO had given me great feedback about a leadership development session I offered. She condescendingly said to me, “Oh, Anne, he says that to everyone. But here are some golf balls. Great job, kiddo.” I am motivated by feedback, recognition and appreciation. She assumed that what would motivate her would motivate me, but she was wrong. So she didn’t motivate me—she completely deflated me.

Sometimes supervisors try to motivate employees with perks—“carrots” like a gift card, paid time off, a great parking spot. These might initially work, but people will start wanting and feeling entitled to more. And to continue improving performance, bigger and better incentives become unnecessarily mandatory.

Negative motivators are a go-to, too—“sticks” like fear of failure, fear of no respect, fear of losing money. Some people are able to motivate others in the short term by using the stick of fear, but it never lasts… and it never produces the best results.

The problem with all these motivators is that they wear off. The carrot and the stick are the old ways of “motivating others.” And they are the ones managers, parents and other would-be motivators usually try first.

Helping someone find the inner motivation to do something is really about personal leadership and influence. The true question is not, “How can I motivate someone?” It’s, “How do I create a climate that taps into what already motivates this person?”

My former golf ball-giving boss might not have understood this, but I recently coached a senior-level executive at a Fortune 100 company on how to do it right. She had been struggling with her team’s performance. While they were meeting the bare minimum, they rarely strived to achieve more. I asked how she currently approached motivation. She said that she gave them gift cards to restaurants. What she didn’t understand was that eating great food was what motivated her, but it might not be the case for her team.

Motivation happens one person at a time. So she began to invest time in building relationships with the people on her team and learned that while some craved opportunities for advancement, others sought paid time off and some just wanted more recognition for a job well done. When she took the time to identify what already motivated her staff, she was able to provide a climate that supported it.

It’s important to be aware of the most common motivators, too—ones that stick, that can spur people to work harder, take risks and change behaviors. People universally crave respect, peace of mind, success, recognition, financial stability, admiration and love.

Whatever situation you’re in, at work or at home, you’re more likely to get what you need and have win-win outcomes if you are able to understand both what motivates you and others. If you want to create an environment where people want to help you and do things for you, where they’re growing and improving, you have to find out what drives their behavior.

The bottom line is this: WIIFM, or What’s in it for me? And discovering this is the secret to motivation.

So how do you find out people’s WIIFM? Try these strategies:

  1. Pay attention:

If you pay attention to what people talk about, what they are interested in and what they focus on, you can often get a sense of what naturally motivates them.

  1. Ask:

It may seem fairly simple, but when was the last time you asked people what you could do to help them stay motivated?

  1. Figure out what de-motivates someone and stop doing it:

It’s not rocket science. If you know someone hates to be nagged, talk with them about the way they would like to be approached when there are things to do. If you know that someone gets embarrassed easily, make a concerted effort not to put the person in uncomfortable situations.

Source: http://www.success.com/article/stop-trying-to-motivate-people-it-wont-work

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Tags: motivation

25 Sales Prospecting Tips to Crush Your Next Call [Infographic]

Posted by www.psmbrokerage.com Admin on Tue, Mar 22, 2016 @ 12:07 PM


Prospecting doesn't tend to be sales reps' favorite part of their jobs, and if you rely on cold calling to generate leads, it's no wonder. Cold calls are awkward for the salesperson, annoying for the buyer, and unproductive for the business. There's really no upside.

With this in mind, we present to you the most valuable sales prospecting tip a modern rep can get: Stop cold calling. Today's buyers don't take kindly to spammy salespeople rambling off a generic script.

So what do they respond to? Warm calls. Salespeople who research their prospect before picking up the phone, demonstrate genuine concern about buyers' specific problems, and freely offer help and guidance are far more successful than their cold calling peers.

The following infographic from AG Salesworks lists 25 bite-sized sales prospecting tips that reflect the new era of inbound sales. Ditch the script, and get hip to the personalization and research game.


Source: http://blog.hubspot.com/sales/phone-prospecting-tips-infographic

Additional Updates:

Tags: prospecting

7 Strategies to Make Referral Selling Incredibly Effective

Posted by www.psmbrokerage.com Admin on Wed, Mar 16, 2016 @ 08:57 AM


Not every prospect is ready to jump in and do business with us right away. That’s why it’s so important for salespeople to remain professionally persistent with new prospects. Sales deals require multiple touches to close, so reps who give up after just one or two communications won’t see success.

But salespeople must be careful to balance their perseverance with good judgment, especially when referrals are involved. Here are seven critical things to remember when selling to referrals.


 7 Strategies to Make Referral Prospecting Incredibly Effective

1) Always be respectful.

Remember – These prospects have been referred or, better yet, introduced to you, so you must treat them like royalty. It’s not just your reputation on the line. Your referral source’s relationship with this prospect might also suffer if you act unprofessionally, and that’s a poor way to repay somebody who’s helped you out.

2) Leverage your relationship.

Use the information you learned about this prospect from your referral source to present and maintain a more compelling reason for them to move forward with you. When you tie your prospecting efforts to what’s most important to them at the time, you’re more likely to spark and maintain their interest.

3) Present yourself as an extra set of hands.

When approaching new prospects, present yourself as an “additional resource.” Avoid the appearance that you’re trying to replace any current relationships and your prospects will be more receptive to you. Even if they’re not happy with their current vendor, they may be stuck in inertia and not receptive to change. Coming in as an additional resource will be easier for them to consider.

4) Keep your referral source in the loop.

Your referral source can assist you in determining how persistent you should be with their friend or colleague. If you have trouble reaching your prospect or they seem unresponsive, let your referral source know. They will advise you how to proceed without hurting any relationships and will appreciate you considering their perspective.

5) Formulate an outreach plan.

Have at least five to seven touch points pre-planned for your prospecting efforts. You need to be flexible to be successful in sales, but it’s better to start with a plan than to make it up as you go.

Most salespeople give up after two or three attempts, even though study after study demonstrates that it usually takes five to seven contacts to bring your prospect to a decision. The best way to ensure your outreach sequence follows a logical progression is to plan it first.

6) Provide value in every touch.

In each touch point, provide some additional value. Compile a series of articles, videos, or links to other related resources that build on each other in a logical progression. You can include one of these resources each time you reach out to your prospect. By including information from sources other than yourself, you demonstrate that the value of knowing you goes beyond just your own expertise.

7) Go for the “no.”

If your prospect keeps putting you off after repeated (appropriately-timed, so you don't appear aggressive or needy) attempts to connect, it could be time to go for the no. Here’s an example of how I might approach a referral who wasn’t responsive:

Bob – I appreciate your willingness to continue to explore how I might become an additional resource for you. I get the feeling that perhaps you don’t see the fit and you’re too nice a guy to just say ‘no’ to me. Would you prefer that I stop contacting you at this time?

You should adjust this wording to fit your style, but you get the idea.

When you go for the no, one of two things usually happens.

You learn more information that allows you to adjust your approach and keep the courtship alive.

You are able to release this prospect and spend your time and energy with other clients and prospects.

Don’t wing it when it comes to being appropriately persistent with qualified prospects. And don’t give up too early. Have a plan, work the plan, and be flexible as you learn more information about the prospect along the way.

Source: http://blog.hubspot.com/sales/referral-selling-effective-strategies 

Additional Updates:

Tags: Referrals, Sales Strategies

Majority of Drugs Now Subject to Coinsurance in Medicare Part D Plans

Posted by www.psmbrokerage.com Admin on Fri, Mar 11, 2016 @ 08:28 AM


A new analysis from Avalere finds that a majority of prescription drugs covered by standalone Medicare Part D plans (PDPs) are subject to coinsurance, rather than copayments, in 2016. Coinsurance is when a beneficiary pays a percentage of the cost of the drug, rather than a fixed dollar amount, or copayment. Coinsurance often leads to patients paying more out of pocket compared to fixed dollar amount copayments. The average percentage of covered drugs facing coinsurance has risen sharply from 35 percent in 2014 to 58 percent in 2016 among PDPs. While most PDPs have historically applied coinsurance to high-cost drugs on the specialty tier, plans have extended coinsurance to drugs on lower tiers in recent years, including those covered on preferred and non-preferred brand tiers. Avalere notes that the increase in the use of coinsurance could have far reaching effects, considering 24.6 million Medicare beneficiaries enrolled in PDPs in 2016.


“As coinsurance becomes more common in Part D plans, consumers will find their drug costs are less predictable and will need to rely more on tools like the Medicare Plan Finder to help estimate out-of-pocket costs,” said Colin Shannon, senior manager at Avalere.

Health plans use formulary tiers to encourage use of lower-cost drugs and to negotiate rebates from drug manufacturers in exchange for placement on a lower tier. These strategies help keep premiums low for consumers. In recent years, the percentage of beneficiaries enrolled in PDPs with more than one tier requiring coinsurance has spiked to 96 percent in 2016, up from 39 percent in 2014.

While Medicare rules cap the amount of coinsurance for specialty tiers at 33 percent of the cost of the product, the maximum on non-preferred brand tiers is 50 percent in 2016. By comparison, preferred brand tier coinsurance amounts are capped at 25 percent. 

“These very high rates of coinsurance have shifted our understanding of Part D formulary coverage,” said Caroline Pearson, senior vice president at Avalere. “It will be important to monitor what drugs are being placed on various coinsurance tiers and how plans are using these tiers to manage cost and utilization in the program.”

Interestingly, Medicare Advantage prescription drug (MA-PD) plans use coinsurance much less frequently than standalone PDPs. In 2016, MA-PDs charge coinsurance for only 26 percent of covered drugs—typically for specialty drugs. MA-PD plans may have an incentive to cover drugs at a lower beneficiary cost because they are also responsible for the medical costs of their enrollees, and their incentive to tightly manage drug costs is lower due to their ability to buy down drug premiums using medical cost savings.


This analysis was conducted using Avalere Health’s DataFrame® database, a proprietary database of all stand-alone PDPs and MA-PD plans that uses the Centers for Medicare & Medicaid Services (CMS) data on Medicare Part D plan, MA-PD plan, and formulary design. It also includes additional proprietary and public data sets.

Analysis of 2016 Part D and MA-PD plans uses enrollment data released in February 2016, formulary data released in October 2015, and updated benefit design data released in October 2015.

  • Data reflect benefit design information as submitted by the plans to CMS.
  • A PDP plan in this context is a single product offered in one of the 34 PDP regions.
  • An MA-PD plan in this context is a single option with a unique contract and plan identification number offered in a county; a plan sponsor may offer more than one plan in a county and may serve multiple counties.
  • Plans in U.S. territories, cost plans, special needs plans (SNPs), and Medicare-Medicaid plans (MMPs) are excluded from the analysis.

The top 10 PDPs in this analysis reflect February 2016 enrollment. In 2016, there are 886 PDPs available to enrollees. CMS has placed sanctions on 91 plans and does not report formulary information for those plans. In addition, only blank data is available for four PDPs. All 95 of these plans are excluded from this analysis. In 2016, there will be 1,679 MA-PD plans offered to enrollees. Data for ten plans was not included in the October 2016 formulary file released by CMS.

Source: http://avalere.com/expertise/managed-care/insights/majority-of-drugs-now-subject-to-coinsurance-in-medicare-part-d-plans

Additional Updates:

Tags: Medicare Part D, Prescription Drugs, Coinsurance

Primary Care Physicians Accepting Medicare: A Snapshot

Posted by www.psmbrokerage.com Admin on Fri, Mar 04, 2016 @ 09:05 AM


Policymakers, researchers, and the media have periodically raised questions about the ease or difficulty that Medicare patients experience when trying to find physicians who will see them. Previous studies show that the vast majority of physicians accept Medicare, but the proportion taking new Medicare patients is smaller, particularly among primary care physicians compared with specialists.1 Primary care is especially important for people with Medicare—55 million seniors and adults with permanent disabilities—because they are significantly more likely than others to have multiple chronic conditions.

This Data Note presents findings on reported acceptance of Medicare patients among non-pediatric primary care physicians, based on data from the Kaiser Family Foundation/Commonwealth Fund 2015 National Survey of Primary Care Providers. In addition to comparing physicians’ acceptance of Medicare to private insurance and Medicaid, this Data Note also explores the characteristics of non-pediatric primary care physicians who accept new Medicare patients and who have greater shares of Medicare patients in their caseloads. This analysis is limited to non-pediatric primary care physicians, given its Medicare focus. The methodology for the survey is provided in the Appendix.

Patient acceptance by type of insurance

The vast majority of non-pediatric primary care physicians (93 percent) say they accept Medicare—comparable to the share accepting private insurance (94 percent) (Figure 1). A majority of primary care physicians also say they are also taking new Medicare patients (72 percent), but this share is somewhat lower than the share of primary care physicians accepting new privately insured patients (80 percent).


Figure 1: More than 9 in 10 primary care physicians accept Medicare—similar to private insurance—but acceptance of new Medicare patients is comparably lower

Compared with Medicare and private insurance, a lower share of non-pediatric primary care physicians—67 percent—say they accept Medicaid, the state-federal program that focuses primarily on coverage for children and adults with low-incomes. If pediatricians were included in the analysis of Medicaid acceptance, the share of physicians accepting Medicaid increases to 71 percent, reflecting the higher rate of Medicaid acceptance among pediatricians—84 percent. (Children account for almost half of the Medicaid-covered population.2) Further analysis of Medicaid acceptance among primary care physicians is discussed in a recently released issue brief by the Kaiser Family Foundation and the Commonwealth Fund.3

Primary care physicians who indicate that they are not taking new patients of a given insurance may have “closed practices,” which means they are not taking any new patients, regardless of insurance. In fact, in a separate survey question, about 2 in 10 primary care physicians (19 percent) report that they are not currently taking any new patients (not shown).

Primary care physicians taking Medicare

Demographic analysis reveals some differences in the rates at which different types of physicians report accepting new Medicare patients. For example, 83 percent of primary care physicians who self-identify as Asian accept new Medicare patients, similar to the 86 percent among physicians who self-identify as either Black, Hispanic, or of another or multiple races (Figure 2). In contrast, a lower share of white primary care physicians (66 percent) say they are accepting new Medicare patients. Notably, while higher shares of Black and Hispanic primary care physicians accept new Medicare patients, Black and Hispanic physicians continue to comprise a relatively small share of the overall non-pediatric primary care physician workforce.4


Figure 2: Acceptance of new Medicare patients is higher among Asian, Black, and Hispanic primary care physicians, though they make up a relatively small overall share of primary care physicians

About two-thirds (67 percent) of primary care physicians age 55 or older say they accept new Medicare patients compared with about three-quarters (76 percent) of primary care physicians under age 55 (Figure 3). Younger doctors may be more likely to be building their patient caseloads and, therefore, may be more willing to take new patients. Alternatively, older physicians may have fuller practices and have less capacity to accept new patients. In fact, 78 percent of non-pediatric physicians age 55 and older say they are accepting new patients (regardless of insurance) compared with 83 percent among their younger counterparts (not shown).


Figure 3: Younger primary care physicians are more likely to accept new Medicare patients, but little difference is seen between male and female doctors

There is little difference between the share of male and female non-pediatric primary care physicians accepting new Medicare patients, though males comprise about two-thirds of the total non-pediatric primary care workforce.

In rural areas, a somewhat higher share of primary care physicians (81 percent) report accepting new Medicare patients relative to their counterparts who practice in cities (72 percent), but differences from cities compared to suburban areas or small towns are not statistically significant (Appendix Table 1). Further analysis by the demographics of physicians’ patient caseloads (income and race, for example), type of practice (such as, hospital-owned or independent practice), does not reveal notable differences regarding acceptance of new Medicare patients. Appendix Table 1 provides these results in more detail.

Primary care physicians with relatively high shares of Medicare patients

About one-third of non-pediatric primary care physicians (32 percent) say that at least half their patients have Medicare (Figure 4). This cohort of physicians with the highest share of Medicare patients in their caseload is disproportionately male and older. Among physicians for whom at least half their patients have Medicare, 82 percent are male and 60 percent are age 55 and older. In comparison, among physicians with lower shares of Medicare patients in their caseloads, 58 percent are male and 37 percent are age 55 and older.


Figure 4: For one-third of primary care physicians, at least half their patients have Medicare; these doctors are disproportionately male and older

The Medicare patients of these older doctors have likely been in their caseloads for a long time, given results from other surveys which find that more than 90 percent of people age 65 and older say they did not look for a new primary care physician during the year.5 Therefore, to the extent that Medicare patients are longtime patients of their primary care doctors, the disproportionate share of males in the cohort of physicians with the highest shares of Medicare patients may reflect, to some extent, the relatively low proportion of female physicians three or so decades ago.6

Further considerations

With the Medicare population aging and increasing by about 2 million each year, efforts to monitor Medicare beneficiaries’ access to primary care are critical. In addition to physician surveys, including the one used for this Data Note, patient surveys are useful to draw a complete picture of access to care. In recent years, national patient-level surveys find that the large majority of Medicare beneficiaries report that they have a usual source of care, can find new doctors when they need one, and can get timely appointments, particularly if experiencing an illness or injury.7 Nonetheless, subsets of Medicare beneficiaries—including beneficiaries with no supplemental insurance or Medicaid and beneficiaries under age 65 living with a permanent disability—report experiencing higher rates of problems finding doctors.8 Further analysis of differences between communities across the country may reveal local market-level variation in access to primary care and could have further policy implications for Medicare.

Source: http://kff.org/medicare/issue-brief/primary-care-physicians-accepting-medicare-a-snapshot/

Additional Updates:

Tags: Medicare, Primary Care Physicians, Patient Acceptance

CMS proposes hike in Medicare Advantage payments; health insurer shares rise

Posted by www.psmbrokerage.com Admin on Fri, Feb 26, 2016 @ 08:54 AM


Insurers that offer Medicare Advantage health plans are facing less pressure to cut benefits and pull out of some markets next year following a favorable early assessment of factors affecting rates.

Late last week, the Centers for Medicare & Medicaid Services (CMS) announced a proposal to hike Medicare Advantage rates by 1.35 percent on average for 2017.

While hiking the rates won’t likely come close to covering all costs involved in administering the program, CMS said plans that work toward enhancing the quality of care delivered to enrollees may see advanced updates to cultivating which benefits are offered.

Determining how much of an impact the rate hike will have on enrollees is quite difficult to say, but the final rate alteration will vary depending upon factors such as where the plan is located.

CMS also floated changes in how risk adjustment would be designed for Medicare Advantage plans that serve many seniors dually eligible for both Medicare and Medicaid.

Medicare Advantage plans have undoubtedly become a key source in growth for insurers offering the health plans. With the rate hike, high pressures felt by insurers over recent years due in part to reimbursement cuts called for by the Affordable Care Act (ACA) will slowly start to diminish.

Following last week’s announcement, one of the largest Medicare Advantage providers (Humana Inc.) saw shares jump out ahead of the broader market at the start of trading Monday. Humana’s stock increased 2.4 percent, or $3.97 to $169.31, as broader trading indexes climbed around 1 percent.

While the final rates for 2017 will be announced in early April, both insurers and enrollees have much to look forward to in the year to come. Interested in selling Medicare Advantage plans? Contact our expert team of Marketers today at + 1 (800) 998-7715 and they'll get you going on the certification process!

Source: http://thehill.com/policy/healthcare/270080-cms-proposes-small-increase-in-medicare-advantage-payments

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Tags: Medicare Advantage plans, Medicare Advantage, CMS

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