The New England Journal of Medicine released a study on Medicare recipients finding themselves back in the hospital less than 30 days after their original discharge in 2003 and 2004. The study found one in five of these patients was readmitted and as many as three-quarters of those could have been prevented. The best way to avoid readmissions is coordinating care from the hospital to those responsible for the next phase of the patient’s recovery. Confirming the patient has the best medicine, knowledge of proper diet, and follow-up appointments is crucial to overall recovery and to prevent their hospital readmission. MedPAC estimated that in 2005 hospital readmission cost Medicare $15 billion, $12 billion of which could have been prevented with the proper knowledge of the patient and their care taker. The proposed health care law hopes to reduce these costs by penalizing hospital with a higher than expected readmission rate starting with 1% of Medicare payments in 2012 and increasing in the next years.
What do you think of the way the Piedmonth Hospital in Atlanta is handling readmissions? Do you think cutting payments to hospitals will help them to follow suit?
Study Shows Elective Surgery in Medicare Beneficiaries Varies by Region
In a study from the Dartmouth Atlas Project of elective procedures in patients over 65, and receiving Medicare, the researchers found regional differences in the way doctors treat their patients. Shannon Brownlee, of the Dartmouth Institute for Health Policy and Clinical Practice, explains that this difference is “the by-product of a doctor-centric medical delivery system.” The study focused on Medicare data from 2003 to 2007 on the rates of some elective procedures, from mastectomies for breast cancer to carotid artery surgery and found that doctor’s opinions on the surgeries varies greatly by cultures of care, how doctors are trained, and the history of where there medical practice is established. This finding suggests that patient preferences are not necessarily being taken into account when they should be.
What do you think of the findings of this study? Do you think Medicare beneficiaries should be more involved in their care, no matter what region of the United States they live in? Or do you think doctors should make the right choice for their patients?
"Pie Chart" by Nick Anderson, the Washington Post
Assured Life Medicare Supplement Now Available in Virginia
Why Sell Medicare Supplements Over the Phone
Also - Discover the pros of selling Medicare Supplements over the phone in our blog post.
Sources: KHN, Routers
Medicare Blog | Medicare News | Medicare Information
If you are just getting into selling in the senior market or you have been in the industry for a long time, selling Medicare Supplements over the phone is a great way to help grow your business. When you sell over the phone, you broaden your selling horizons beyond your immediate driving area and give yourself a virtually unlimited selling area with little to no travel necessary. Also, you can connect with a whole new market in a different city or state, no matter the distance from you. When you sell Med Supp over the phone, you can begin prospecting in an area with a larger senior population than the one you currently live in, all from the comfort of your home or office.
This week Republican Denny Rehberg put up an amendment to the pending House bill to fund the final seven months of the yearly budget and prohibit administration from using any of the money to put the health-care law into effect. His proposal is likely to make it into the House budget bill. However, Rehberg's bill faces two obstacles: the Democrats control of the Senate and the White House and that most of the funds needed for the law were put into the law itself. The only way to have access to those funds is for Congress to enact legislation rescinding them, which will be hard to do since the Republicans currently only have majority in the House. Therefore, Republican House members are putting wording in the budget bills stating that none of Congress’ operating costs for federal agencies can go toward the health-care law. The money in question is not actually for the law itself, but the administration costs needed to carry it out. If the spending bills are adopted, they could cause these processes to stop. Richard Sorian, spokesman for the Department of Health and Human Services uses the example "Even though the funds for seniors’ checks are not affected, the salary of the person mailing it out is."
What do you think of the efforts by the Republicans to defund the health-care law? Do you think they will be successful? Do you think Congress will be able to come to an agreement by their deadline of March 4, 2011?
Grow Your Business Online - PSM Can Show You How
United of Omaha Now Available in Maine
Effective February 16, 2011 United of Omaha is available in Maine – please see the United of Omaha Maine Rates and Application.
Assured Life Now Available in Tennessee
Sources: KHN, The Washington Post, The Hill
Starting in January more affluent seniors have begun to pay higher premiums for their prescription drug benefits. Since 2007 high income beneficiaries have paid more on a sliding scale for Medicare Part B but this is the first year that scale has included Medicare Part D as well. Additionally, the provision in the health care law froze the income threshold that determines their costs, and it will not be adjusted for inflation through 2019. Senior advocates warn that requiring high-income seniors to pay more for their Medicare premiums might encourage them to look elsewhere for their insurance coverage. This could be significant, as wealthier seniors also tend to be healthier, thus affecting the lower-income seniors left behind with increases. Still, supporters believe it makes sense to require seniors with higher incomes to pay more for their Medicare benefits because it is guarantee issue and community-rated. Switching to private insurance is risky and they doubt that seniors could get a better deal. At this time, James Blum, deputy of the Center for Medicare and Medicaid Service, is not aware of anyone leaving the program because of higher prices for their Part B coverage. Blum is confident more affluent seniors will continue to stay in the Part D program as well, citing that the Part D plan is generous and the 50% discount (beginning this year) on prescription drugs once they reach the doughnut hole. In the past, roughly 5% of Medicare beneficiaries had been paying the higher premiums; however, with the sliding scale no longer in place this will increase to 10% by 2019 raising approximately $36 billion for Medicare.
How do you feel about affluent seniors having to pay higher premiums for their Medicare Part D coverage as well?
The Diminishing Medicare Doughnut Hole
Starting in 2011 seniors who hit the doughnut hole will have substantial discounts on their prescription drugs, increasing over time and completely closing the gap by the year 2020. This is a significant part of the health care law because in the past those who reached the gap often stopped filling their prescriptions due to the financial burden. Previously, Medicare beneficiaries were responsible for 25% of their prescription drug cost and their drug plan paid the extra 75% until they reach a total of $2530 at which time the senior entered the doughnut hole. However starting this year after reaching the doughnut hole beneficiaries will get a 50% brand-name and 7% generic drug discount until they have spent $3607.50. At that time the senior will be out of the doughnut hole and the drug plan will cover approximately 95% of the prescription drugs for the remainder of the year. By 2020 Medicare beneficiaries will only be responsible for 25% of their bill, no matter how large. This year alone the new plan will save approximately 4 million low-income seniors up to $1800 each. However critics believe this will result in drug companies raising the price on their drugs, to cover the difference. A price increase would affect all of those on Medicare not just those in the doughnut hole, creating another problem needing a solution.
What do you think of the new Medicare Part D benefit? Do you think drug companies will raise their prices to cover the difference?
United of Omaha Approved in CA, NE and SD
Effective February 3, 2010 United of Omaha is released in Nebraska and South Dakota – please see the United of Omaha Nebraska Rates and the United of Omaha South Dakota Rates.
Forethought Now Available in KS and UT
Effective February 2, 2011 Forethought is released in Kansas and Utah – please see the Forethought Kansas Rates and Application and the Forethought Utah Rates and Application or call 1-800-998-7715 to get contracted.
Mutual of Omaha has announced underwriting changes to their Plan N Medicare Supplements. This will affect all Mutual of Omaha companies including United World and United of Omaha. Exceptions will include New York, where health questions may not be asked (per state regulations) and in open enrollment or other guarantee issue situations where health questions normally do not apply.
New Application (Required after February 16, 2011)
The underwriting changes will also bring about new applications. Where the new applications are already approved, the new underwriting guidelines will be effective with applications signed on or after February 16th 2011. The states are where the new applications have already been approved are:
This change will also affect commissions on Plans M and N. Mutual of Omaha will have new commission schedules available shortly, but you can expect commissions on all plans to be uniform.