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Can Dental Benefits Become a Competitive Advantage?

Posted by www.psmbrokerage.com Admin on Tue, Oct 15, 2019 @ 03:52 PM

Source: https://blog.deftresearch.com/can-dental-benefits-become-a-competitive-advantage

Additional Updates:
 

Tags: Medicare Advantage, dental

92% of Humana’s Medicare Advantage Members are in 4-Star and Above

Posted by www.psmbrokerage.com Admin on Tue, Oct 15, 2019 @ 03:38 PM

Source: https://humana.gcs-web.com/news-releases/news-release-details/92-humanas-medicare-advantage-members-are-4-star-and-above

Additional Updates:
 

Tags: Humana, Medicare Advantage

Part D Out-of-Pocket Costs to Spike in 2020

Posted by www.psmbrokerage.com Admin on Tue, Oct 15, 2019 @ 11:48 AM

Part D Out-of-Pocket Costs to Spike in 2020

Part D Out-of-Pocket Costs to Spike in 2020-1

Part D catastrophic threshold to spike in 2020, hiking out-of-pocket costs: KFF report

Kaiser Family Foundation (KFF) researchers examined how policy changes could impact the Part D market for the 2020 plan year and found that the catastrophic threshold is set to increase substantially, leading to higher out-of-pocket costs for certain beneficiaries. 

The catastrophic threshold for 2020 will rise from $5,100 in 2019 to $6,350, KFF found. That’s an increase of $1,250, or 25%.

Beneficiaries who take only brand-name drugs will pay for a quarter of that increase out of their pockets, while the rest will be covered by drugmaker discounts. Beneficiaries who take only generic drugs will pay the entire increase out of pocket, according to the report. 

 

RELATED: Part D rebates grew but not enough to offset price spikes, OIG finds 

The report projects that out-of-pocket costs for beneficiaries who take only brand-name drugs will increase from $2,275 in 2019 to $2,652 in 2020, or close to $400. The researchers said that the large increase is due to the expiration of a provision within the Affordable Care Act that slowed the growth of the catastrophic threshold. 

“In the absence of a change in law, Medicare Part D enrollees can expect to face an increase in their out-of-pocket drug costs in 2020,” the researchers wrote. 

Based on 2017 claims data—the most recent available—the report says 4.9 million Part D beneficiaries who do not receive low-income subsidies reached the coverage gap, and 1 million reached the catastrophic coverage threshold. 

Had the threshold increased in 2017, fewer than 1 million people would have qualified for catastrophic coverage, meaning more people would be paying out of pocket in the coverage gap. 

The findings are notable in part, the researchers said, because some legislators are actively seeking ways to cap beneficiaries’ out-of-pocket costs. The drug pricing plan backed by House Speaker Nancy Pelosi would do so, alongside shifting some of the liability for costs for beneficiaries who do reach the catastrophic threshold. 

“Proposed changes to the Part D benefit design would help to mitigate out-of-pocket drug cost increases for Medicare beneficiaries, particularly for those with high drug costs who currently face no limit in their annual out-of-pocket expenses—with Part D plan sponsors and drug manufacturers potentially picking up much of the additional costs,” the researchers wrote. 

Source: https://www.fiercehealthcare.com/payer/part-d-catastrophic-threshold-set-to-spike-2020-increasing-out-pocket-costs-kff-report

Additional Updates:
 

Tags: Medicare Part D

Medicare Advantage, Part D members shifting to higher-rated plans

Posted by www.psmbrokerage.com Admin on Tue, Oct 15, 2019 @ 11:07 AM

Medicare Advantage, Part D members shifting to higher-rated plans

Medicare Advantage, Part D members shifting to higher-rated plans


CMS unveiled star ratings for both Medicare Part D prescription plans and Medicare Advantage plans that show even more of the plans achieving higher star ratings.

The number of Medicare Part D prescription drug plan members who will be in plans with four stars or more in 2020 rose to 27.6%, up from just 3.5% last year, according to data released by the CMS on Friday. The percentage of four-star or greater Medicare Advantage Part C plans with prescription drug coverage grew to a whopping 81.1% of members in 2020, up from 75.3% in 2019.

The topic of lopsided star ratings toward the high end of the scale has been a sticking point with the Medicare Payment Advisory Commission, which believes $6 billion a year could be saved by revamping the way stars are awarded in the Medicare Advantage program.

Medicare prescription drug plans 2020 star ratings

The percentage of Medicare Part D prescription drug plan members in plans with four stars or more in 2020 rose sharply from the year before.

The average star rating of Part D plans, which are managed by pharmacy benefit management companies and health insurers, has bobbed up and down for years but has always hovered below four stars. The average star rating across the 54 Part D contracts in 2020 was 3.5, up from last year's average rating of 3.34.

Enrollment in Part D prescription drug plans with fewer than three stars dropped to 0.8%, compared to 6.2% last year. Just 5.6% of Part D plans received below three stars, whereas 9.6% did in 2018.

Meanwhile, more than 200 Medicare Advantage plans offering prescription drug coverage, representing 52.4% of these plans for 2020, received at least four stars. Last year, 172, or 45.7% of plans, were part of that category. The average star rating for Medicare Advantage plans with prescription drug coverage was 4.16 for 2020, up from last year's 4.06. Medicare Advantage plans with fewer than three stars dropped to 15%, compared with 21.3% in 2019.

Higher rated plans get larger share of enrollees

More people were enrolled in Medicare Advantage plans with prescription drug coverage that had 4.5- or 5-star ratings.

The CMS star rating system for Medicare's private insurance coverage is meant to hold insurers accountable for the care provided to their members.

Health plans have a financial incentive to provide better quality care for their members, because those that garner four or more stars receive a 5% boost to their monthly per-member payments from Medicare.

Twenty-three individual plans scored five stars for 2020. Twenty of those were Medicare Advantage plans offering prescription drug coverage, including nine new contracts that had not earned the high performing indicator last year. Two of the plans were stand-alone prescription drug plans and one was a Medicare Advantage-only plan.

CVS Health, Humana, UnitedHealth Group and Kaiser Foundation Health Plan were among companies offering five-star plans.

Five individual plans covering more than 73,000 people received a warning from the CMS for consistently low quality ratings. Those plans—owned by QHP Financial Group, Delaware Life Insurance Co., Centers Plan for Healthy Living, Universal Health Services and Magellan Health—have earned ratings of 2.5 stars or fewer for a Medicare Advantage or Part D contract since at least 2018.

CMS Administrator Seema Verma said in a statement that the star ratings in the Medicare Advantage and Part D programs indicate that "seniors will have access to more high-quality plans," and pointed to projections the agency released last month suggesting that in 2020 Medicare Advantage average monthly premiums will hit their lowest point in 13 years.

Source: https://www.modernhealthcare.com/medicare/medicare-advantage-part-d-members-shifting-higher-rated-plans


Additional Updates:
 

Tags: Medicare Advantage, Medicare Part D, star ratings

How To Deal With Difficult Customers

Posted by www.psmbrokerage.com Admin on Mon, Oct 14, 2019 @ 01:23 PM

How to Deal with Difficult Customers


Bill Gates once said, “Your most unhappy customers are your greatest source of learning.”

dealing with difficult customersAlthough you can learn a lot from an unhappy customer, a big part of running a successful business is keeping long term, happy customers.

When your customers are happy your business will grow. When they are not, you may start to have problems.

There are many different types of difficult customers you may encounter. Some may just require more information. Some may just be rude and disrespectful.

Whatever the situation, it’s important to know how too deal with anything that arises.

Below, is an Infographic from Fundera that lays out nicely how to respond to a number of different types of difficult customers.

Always try to learn from each of your experiences. If a customer responds to your efforts positively, learn from that experience so you can do it again.

If a customer just wouldn’t come around, remember that too. If you can identify that type of customer sooner, you can save yourself time and frustration in the future.

Just remember, if you are not able to connect with the customer and turn things around quickly, you are likely eating into your bottom. Don't wait too long before cutting your losses.


difficult-customers

 

 
 

Tags: Sales Strategies

Medicare Advantage Enrollment Grows 8% Year-Over-Year

Posted by www.psmbrokerage.com Admin on Fri, Oct 11, 2019 @ 01:03 PM

Medicare Advantage Enrollment Grows
8% Year-Over-Year

8%

Gains Concentrated Among Major Players

Medicare Advantage enrollment grew 8.0% from September 2018 to September 2019, according to AIS’s Directory of Health Plans (see a complete month-by-month timeline below), continuing a trend of greater MA gains as more baby boomers, seeking more personalized benefits, age into Medicare. In advance of the Annual Election Period (AEP) starting on Oct. 15, CMS on Sept. 24 said it expects MA enrollment to reach new highs in 2020, growing about 10% to 24.4 million lives.

Growth this past year was concentrated among the largest payers in the MA space, with the top five experiencing enrollment gains of about 16% on average year over year (see breakdown below). The big winner was Aetna Inc., which took on its largest-ever MA expansion in 2019, adding its offerings to more than 350 new counties.

While still on top, market leader UnitedHealthcare’s post-AEP gains were smaller than the 400,000 to 450,000 members (excluding dual eligible Special Needs Plans) the company anticipated, instead adding only about 290,000 lives.

NOTE: All enrollment totals include dual eligible Special Needs Plans (D-SNPs) except where noted. AIS defines post-AEP enrollment as total MA membership as of February 2019.

Source: https://aishealth.com/medicare-and-medicaid/medicare-advantage-enrollment-grows-8-year-over-year-with-gains-concentrated-among-major-players/


Additional Updates:
 

Tags: Medicare Advantage, UnitedHealthcare, aetna

CMS Releases Star Ratings for 2020 Medicare Advantage and Part D Drug Plans Ahead of Medicare Open Enrollment

Posted by www.psmbrokerage.com Admin on Fri, Oct 11, 2019 @ 12:49 PM

Star Ratings:
Medicare Plan Choices in 2020

Administration Drives Access to More High-Quality Medicare Plan Choices in 2020

Consistent with the direction of President Trump’s recent Executive Order on Strengthening and Improving Medicare for Our Nation’s Seniors, the Centers for Medicare & Medicaid Services (CMS) announced today that seniors will have access to more high-quality Medicare Advantage and Part D prescription drug plans in 2020. Most people with Medicare will have access to Medicare Advantage and Part D plans with four or more stars in 2020, and approximately 81 percent of Medicare Advantage enrollees with prescription drug coverage will be in plans with four and five stars in 2020, an increase from 69 percent in 2017.

Medicare Advantage remains a popular choice among beneficiaries and has high satisfaction rates. Due to recent actions CMS has made to protect and strengthen Medicare Advantage, Medicare Advantage plans are better able to compete on the basis of cost and quality. As a result, beneficiaries are benefiting from more plan choices, lower costs and increased quality. As announced last month, on average, Medicare Advantage premiums are expected to decline by 23 percent from 2018, and will be the lowest in the last thirteen years for the more than 24 million people with Medicare who are projected to enroll in Medicare Advantage for 2020. Beneficiaries will have more plan choices, with about 1,200 more Medicare Advantage plans operating in 2020 than in 2018.

“President Trump continues to be the great protector of the Medicare program for our nation’s seniors,” said CMS Administrator Seema Verma. “Thanks to the President’s leadership and commitment, the improvements that CMS has made to the Medicare Advantage and Part D programs means that seniors will have access to more high-quality plans. Proposals for more government in our healthcare – such as Medicare-for-All – would eviscerate the progress we’ve made to strengthen the program by empowering patients to make informed choices in choosing high-quality plans that best fit their needs.”

Approximately 52 percent of Medicare Advantage plans that offer prescription drug coverage will have an overall rating of four stars or higher, compared to approximately 45 percent in 2019. The average star rating for all Medicare Advantage plans with prescription drug coverage has improved to 4.16 out of 5 stars, increasing from 4.02 in 2017.

More Medicare beneficiaries will have access to a greater number of high-quality stand-alone Medicare Part D prescription drug plans. In 2020, based on current enrollment, approximately 28 percent of enrollees will be in stand-alone prescription drug plans with 4 stars or higher, an increase from approximately 3 percent in 2018. And the average star rating for a stand-alone prescription drug plan has improved from 3.34 in 2019 to 3.50 in 2020.

Earlier this year, CMS made improvements to the Medicare Advantage and Part D Star Ratings so that consumers can more easily identify high-value and high-quality plans. The Star Ratings methodology was enhanced to better account for differences in a plan’s enrollee population.

The Star Ratings system helps people with Medicare, their families, and their caregivers compare the quality of health and drug plans being offered. Medicare health and drug plans are given a rating on a 1 to 5 star scale, with 1 representing poor performance and 5 stars representing excellent performance. Medicare beneficiaries can compare health coverage choices and the Star Ratings through the online Medicare Plan Finder tool available at Medicare.gov (https://www.medicare.gov). CMS publishes the Medicare Advantage and Part D Star Ratings every year to measure the quality of, and reflect the experiences of beneficiaries in, Medicare Advantage and Part D plans.

It will be easier than ever to compare Medicare Advantage and Part D plans on Medicare.gov. As the 2020 Medicare Open Enrollment period approaches, CMS for the first time in a decade launched a modernized and redesigned Medicare Plan Finder – the most-used tool on Medicare.gov – that allows users to shop and compare Medicare Advantage and Part D plans (including by total costs of estimated annual drug costs plus premiums) as well as compare costs between original Medicare, Medicare prescription drug plans, Medicare Advantage plans and Medicare supplemental insurance (Medigap) policies.

Medicare Open Enrollment begins on October 15, 2019, and ends on December 7, 2019. During this time, Medicare beneficiaries can compare coverage options like Original Medicare and Medicare Advantage and choose health and drug plans for 2020. Medicare health and drug plan costs and covered benefits can change from year to year, so people with Medicare should look at their coverage choices and decide on the options that best meet their health needs. They can visit Medicare.gov (https://www.medicare.gov), call 1-800-MEDICARE, or contact their State Health Insurance Assistance Program.

For more information on the 2020 Medicare Advantage and Part D Star Ratings, including a fact sheet, please visit: https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovGenIn/PerformanceData.html, and download the “2020 Part C and D Medicare Star Ratings Data” zip file in the downloads section.

To view the premiums and costs of the 2020 Medicare Advantage and Part D plans, please visit: https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovGenIn/index.html.


Additional Updates:
 

Tags: Medicare Advantage, Medicare, star ratings

New Medicare Plan Finder - Top 10 Questions and Answers

Posted by www.psmbrokerage.com Admin on Fri, Oct 11, 2019 @ 10:42 AM

New Medicare Plan Finder - Top 10 Questions and Answers
(for those Helping People with Medicare)

Additional Updates:
 

Tags: Medicare, Medicare Plan Finder

New Plan Finder Updates Including Star Ratings. Materials Available Now

Posted by www.psmbrokerage.com Admin on Fri, Oct 11, 2019 @ 10:23 AM

New Plan Finder Updates Including Star Ratings. Materials Available Now

Additional Updates:
 

Tags: Medicare, Medicare Plan Finder

Social Security Benefits Increase in 2020

Posted by www.psmbrokerage.com Admin on Thu, Oct 10, 2019 @ 04:30 PM

Social Security Benefits Increase in 2020

Additional Updates:
 

Tags: Medicare, Social Security

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