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Medicare Blog | Medicare News | Medicare Information

New Medical Technology Increasing Medicare Spending

Posted by Richard Ybarra on Fri, May 21, 2010 @ 11:17 AM

medicare spending increase

 Kaiser Health News has an excellent article on how Medicare costs are increasing rapidly in traditionally low cost areas. The article focuses on the city of Provo, Utah where residents are among the healthiest in the country and its largest hospital is operated by Intermountain Healthcare, an organization praised by President Obama for providing high quality care at reasonable costs. Despite these factors, spending on Medicare patients has increased significantly in the last few years.


According to experts cited in the article, the major reason for this spike in spending is the use of expensive, new technologies, (such as the use of robotics for surgery) many of which are said to introduce little to no improvement over traditional methods. They go on to say that competition forces hospitals to adopt the latest technology, as patients always want the “best” care, which they equate to new technology. The new health care law is only going to exacerbate this problem. Now that reimbursement will be tied to quality health care, not only will hospitals be pressured to use the latest tools and techniques, but they most likely will extend patient stays, and use more aggressive (and expensive) treatments at earlier stages of illnesses.


The article goes on to say that what is happening in Provo, Utah is also happening in other traditionally low cost areas of the nation. The biggest concern among experts in the field is that these spikes are indicative of what will happen throughout the country as more hospitals begin to focus on higher quality care for Medicare patients, just at a more severe level.


Medicare Reimbursements Per Enrollee Interactive Map


CMS Will Spend $73 million to Upgrade its Websites

CGI Federal Inc. was awarded a five-year, $73.2 million contract to upgrade and continue maintenance of Medcare.gov, cms.hhs.gov, and MyMedicare.gov.  Together these sites see 500 million page views each year and provide information to 44 million beneficiaries and millions of other health care providers.

Tags: senior market blog, senior market news, Medicare Advantage, Medicare, Medicare Supplement, Senior Market, Medicare Discussion, Medicare News, senior insurance market news, CMS

“Critical Milestone” Reached in Health Care Reform

Posted by Richard Ybarra on Fri, Oct 16, 2009 @ 11:57 AM

The big news of the week was not so much the passing of the Senate Finance Committee bill as was expect, but rather it was the single Republican vote of support by Maine Senator Olympia Snowe. Snowe stated that the bill is not perfect, but does represent the best balance of what has been proposed thus far. She further commented that the threat of maintaining the status quo is too great to Americans. More liberal Democrats also chimed in stating that the bill was far from their ideal, but supported it with the hope that it could be reshaped later.

President Obama described the passage as a “critical milestone” towards achieving health care reform, as the event advances current health care legislation further than any other attempt over the past several decades.

Now the Finance bill will most likely go through a process of merging with a bill passed earlier by the Health, Education, Labor, and Pensions Committee. The big point of contention will be whether a merged bill will include a public option. The Finance Committee bill doesn’t include it, while the latter does. This process will not be a walk in the park if the merging of legislation approved by three House of Representatives Committees is any indication. The details of a merged House bill are currently the source of much frustration and struggle in the House.

As health care reform progresses, insurance companies and industry representatives are ratcheting up their opposition to much of the legislation currently under consideration. AHIP this week released a PricewaterhouseCoopers Report on the Impact of Reform Proposals on Costs that essentially states that the Finance Committee bill will raise premiums significantly for most people who already have insurance. The report can be read here. The report is currently being criticized for only analyzing four provisions of the bill. Additionally, AHIP is running TV ads in six states criticizing current legislation for making more than $100 billion in cuts to Medicare Advantage and reducing benefits to seniors.

Weekly Recap:

Internet Use Decreases Senior Depression: The Phoenix Center, a non-profit research group, released a report today that shows seniors who use the Internet can reduce their depression by 20%. The report further states that reducing depression can lead to decreased health care costs for both seniors and the industry in general. The report explains that the Internet facilitates increasing communications with family, friends, and society at large especially for seniors who have mobility difficulties. For the full report, click here.

No 2010 COLA Increase Official: On Thursday, the Social Security Administration officially stated that there will be no automatic Cost Of Living Adjustment. The SSA explains that due to the recession there was no inflation this year, thus no need for a COLA increase. To offset this, President Obama on Wednesday announced a $250 Economic Recovery Payment to seniors, veterans, and disabled people who have not recovered from their losses from the recession. The payments are expected to go out to more than 50 million people. For more information click here.

H1N1 Flu Information for Seniors: CMS now has a Web site with information specifically for people on Medicare and Medicaid. Click here to visit the site.

Standard Prescription Drug Benefit for 2010 Info: The Center for Medicare Advocacy, Inc. has a great comparison chart showing info regarding Part D standard benefits Info. For more information on the subject, click here.

Sources: Associated Press, CMS, SSA, CMA, The Phoenix Center


Tags: senior market blog, senior market news, Medicare Advantage, Medicare, Medicare Supplement, Senior Market, Medicare News, senior insurance market news, health insurance news, Medicare Advantage News, health care reform, CMS

Annual Open Enrollment Ramp Up Begins

Posted by Richard Ybarra on Fri, Oct 09, 2009 @ 10:29 AM

As many of you already know, Medicare's Annual Open Enrollment begins November 15 and will last until the end of the year December 31. The Centers for Medicare & Medicaid Services this week released the final $6.3 million of a total $49.6 million in total funding allocated for State Health Insurance Assistance Programs (SHIPs).

SHIPs use this money to fund local community programs that provide personalized help to Seniors who want to know more about Medicare and other health insurance information. SHIP programs are expected to focus heavily on less fortunate Seniors who typically have little knowledge of the Medicare system and the benefits they are entitled to. For more information on the SHIPs in your state, click here.

For this open enrollment season many in the industry expect to see an increase in Medicare supplement enrollments due to several changes to Medicare Advantage that will occur in 2010. MA beneficiaries can expect to see an average premium increase of nearly 22% (a $7 increase to $39/month). Despite the increases, CMS states that roughly 87% of Medicare beneficiaries will still have access to a MA plan that doesn’t require a premium. Additionally, CMS expects 7% of MA beneficiaries will have to choose a new health plan or a Medicare supplement as their plans (typically PFFS and low enrollment plans) will be discontinued at the end of this year.

CMS will also increase its oversight of Medicare marketing activities. There are now stronger rules governing the commissions that can be paid to independent sales agents and how MA plans identify themselves. CMS will significantly increase its secret shopping activities, including individual marketing sessions. So we advise that you be extra vigilant in your compliance efforts this season. Mutual of Omaha has already published its disenrollment guidelines, which you can check out here.

As usual, Seniors will have access to www.medicare.gov and 1-800-MEDICARE this season. Of course, these are good resources for agents such as yourself, if only to ensure that your information aligns with the official source. For all open enrollment related information, click here.

As always, we’ll keep you updated with the latest news and product information to help make this open enrollment season a successful one for your organization.

Sources: CMS, Senior Journal

Tags: Medicare open enrollment, Senior Market Advice, Senior Market Success, senior market blog, senior market news, Medicare Advantage, Health Insurance, Medicare, Medicare Supplement, Senior Market, Medicare Discussion, Medicare News, senior insurance market news, Medicare Advantage News, Medicare Sales, Medicare Advice, CMS, Medicare Solutions

CMS Suspends Medicare Advantage Mailings

Posted by Richard Ybarra on Fri, Sep 25, 2009 @ 02:02 PM

According to National Underwriter the Centers for Medicare and Medicaid Services (CMS) ordered all Medicare Advantage providers to suspend what it considers to be misleading mailings sent to beneficiaries about health care and health reform.

The order was sparked by a mailing campaign conducted by Humana Inc. The mailings conveyed to recipients that current health care reform legislation in Congress would eliminate the entire Medicare Advantage program.

CMS representatives state that the mailings may be in violation of Medicare rules, as Humana’s campaign assets were not submitted to CMS for approval – a requirement for any marketing piece that contains Medicare Advantage benefit information. Humana has agreed to suspend the mailings while a final decision is made.

Representatives from America’s Health Insurance Plans (AHIP) are criticizing the move as unfair and calling it a “gag order.”

Weekly Recap:

World Alzheimer’s Day: On Sept. 21, Alzheimer’s Disease International released a report stating that 5.3 million Americas have the disease. The report also forecasts that 35 million people worldwide will have dementia next year which is primarily caused by Alzheimer’s disease. The most startling fact in the report is its forecast that dementia prevalence will almost double every 20 years to 65.7 million in 2030 and 115.4 million in 2050.

Bill to Stop Part B Increase: A new house bill was introduced that aims to keep Medicare Part B premiums the same. With no Social Security benefit increase next year, an increase in Part B will effectively further reduce the income of senior citizens. The bill is sponsored by Rep. Dina Titus (NV-D), AARP, and several other senior-advocate organizations.

AA Retirees Lose Coverage: American Airlines will discontinue paying for Medicare supplement insurance for its retired, non-union employees because the cost is too high. As of January 1, non-union retirees age 65 and older will have to pay for supplement insurance themselves. Those who participated in the pre-fund program will be reimbursed. Sources: National Underwriter, Senior Journal, Dallas Morning News

Tags: senior market blog, senior market news, Medicare Advantage, Medicare Supplement, Senior Market, Medicare Discussion, Medicare News, senior insurance market news, health insurance industry, Medicare Advantage News, CMS

PSM Agents Get Free Online Promotional Page

Posted by Richard Ybarra on Fri, Aug 28, 2009 @ 04:44 PM

As an organization that sees great success utilizing the latest technology, we are always encouraging our own agents to do the same, especially when it comes to establishing and maintaining a web presence. Since not every one of our agents has the resources to do so, we have developed a free service that provides such agents with an online promotional page.

Our online promotional page service includes development of one web page, graphic design of up to two images, content editing, and a quote form that forwards lead data to your email. That's right, if you are contracted through us for any product, we'll help get you on the Internet at no cost.

There are two major prerequites before we can get started on your page. You need a domain name and a hosting account. If you don't already have these, each can be obtained for a minimal cost at providers such as GoDaddy. For more information about this service, click here.

Weekly News Recap:

Passing of a Leader: Of course, the big news this week was the passing of Massachusetts Senator Edward Kennedy who championed health care reform for nearly 50 years. Whether you agreed or disagreed with his policies, there is no doubt that he faithfully served our country for many years and dedicated his life to improving the livelihood of all Americans.

House Bill Details: The current recess has provided an opportunity for researchers to analyze the bill and make the details known to the public. Two interesting subjects came up this week. First, the Congressional Research Service found that the current House bill allows illegal aliens to receive benefits under a government system. Second, two lawmakers said that a provision in the bill that allows a public health plan to negotiate payments with providers could be dropped by the House panel. Those opposing the provision say it would drive costs up for consumers rather than lower them.

CMS Medicare Project Success: CMS announced on Wednesday that several of its demonstration projects provide strong evidence that financial incentives can increase the quality of care for Medicare patients and reduce the growth of Medicare expenditures. The VBP (value-based purchasing) initiative, the HQID (hospital quality incentive demonstration), and the MCMP (medicare care management performance) demonstration are all showing that actively paying for high quality care is a much better way to manage Medicare than just being a passive payer of any kind of treatment.

Tags: Senior Market Advice, Senior Market Success, senior market blog, senior market news, Web Marketing Advice, Web Tips, Medicare, Medicare Supplement, Senior Market, Medicare News, senior insurance market news, CMS

White House Threatens to Force Senate Reform Bill

Posted by Richard Ybarra on Fri, Aug 21, 2009 @ 09:59 AM

Earlier this week, the White House made a bold announcement to possibly utilize a political process called “reconciliation” to bypass the need for bipartisan support of health care reform legislation in the Senate. With this process, only a simple majority of 51 votes is needed to get a vote on the senate floor rather than the normal 60. Despite the threat, the White House says it is still willing to listen to any perspective and do its best to gain bipartisan support.

According to CNN, a Democratic-only plan would not be supported by the majority of the American public. CNN cited a Quinnipiac University poll that shows 59% of Americans are opposed to a Democratic-only bill with 36% in support. Perception of Republican efforts at health care reform is worse with an NBC News poll showing approval by only 21% of Americans.

Currently, if the White House does choose to execute reconciliation, it will still have to work hard to gain consensus among its own party, as there is still much debate between liberal and conservative Democrats. We’ll keep you posted.

In other news:

AP reports that Medicare drug premiums will see a slight increase in 2010, which will equate to about a $2 rise in seniors’ monthly payment for prescription drug coverage next year. CMS announced that the average monthly premium will be about $30 next year.

An LTC insurance study by the American Association for Long-Term Care Insurance shows that in 2008 nearly 50% of all buyers were under 65, while roughly 10% were between 45 and 54. 66% of buyers were women, and the average single premium was $70,975. This study analyzed more than 5,000 new policies. The overall market outlook from the group is positive with sales expected to increase in the coming years.

Lastly, I came across an interesting press release by ProspectZone on InsuranceNewsNet.com. It discusses how calling new insurance leads in the evenings and weekends is a better way to capitalize on those leads rather than calling during normal business hours. For those of you who do this, do you agree? Do you get a better response when contacting clients during off hours?

Sources: CNN, AP, SMA, INN

Tags: senior market blog, senior market news, Medicare Advantage, Health Insurance, Medicare, Medicare Supplement, Medicare News, senior insurance market news, CMS

CMS Adjusts Medicare Pay to Hospice Care Providers

Posted by Richard Ybarra on Fri, Aug 07, 2009 @ 10:28 AM

At the end of last month, the Centers for Medicare & Medicaid Services (CMS) announced that Medicare payments for hospice care will increase by 1.4% in 2010. The National Hospice and Palliative Care Organization (NHPCO) stated on August 3 that the announcement is a victory for hospice providers who have been long battling against the elimination of the budget neutrality adjustment factor (BNAF).

For those of you not familiar with the subject, the elimination of the BNAF will substantially cut Medicare’s payments for hospice care. This primary reason for the cut provided by CMS is that it improves financial stewardship of the Medicare Trust Fund.

Originally, the Medicare hospice reimbursement cuts associated with the elimination of the BNAF were to occur in 2 years, but the new ruling spreads these cuts out over seven years. The BNAF will be reduced by 10% in FY 2010, and by 15% each year from 2011-2016. Despite the small victory, the NHPCO plans to continue the fight to completely reverse the decision to eliminate the BNAF.

According to the CMS, the hospice payment increase is due to a 2.1% increase in one of its indicators of input price increases, offset by a 0.7% decrease in payments to hospices in accordance with the policy to phase out its wage index budget neutrality adjustment factor. Additionally, the CMS considered the current, harsh economic condition of the hospice care market, and the increasing demand for improved access to such services.

Sources: CMS, Senior Journal

Tags: senior market blog, senior market news, Medicare, Medicare Supplement, Senior Market, Medicare Discussion, Medicare News, CMS

CMS Proposes 21.5% Medicare Payment Cut

Posted by Richard Ybarra on Thu, Jul 02, 2009 @ 10:26 AM

Doctors across America will see their Medicare payments cut by 21.5% starting January 1, 2010 if a proposal by the Centers for Medicare and Medicaid Services (CMS) is passed. CMS is also proposing to remove physician-administered drugs from the formula used to calculate Medicare's fee schedule for doctors.

The latter proposal is backed by the American Medical Association. AMA president J. James Rohack claims such changes to the Medicare physican payment formula are "...a major victory for America's seniors and their physicians."

The 21.5% cut in 2010 will occur unless Congress strikes down the proposal as it has in the past. The large cut is a result of the sustainable growth rate (SGR) factor in the Medicare payment formula, and from Congress stalling earlier proposed payment cuts.

As an example of what could happen under the cuts, the Michigan State Medical Society estimates that physicians in the state could lose roughly $610 million in 2010. Furthermore, in a 2008 survey the society found that 12% of doctors in the state would stop seeing medicare patients, 44% would decrease the number of Medicare patients they saw, and 40% would see still see the normal amount of Medicare patients, but have to cut investments in staff, technology, or quality improvement efforts. The remaining 4% said it would have no effect. Stay tuned for the decision.

Precision Senior Marketing will be closed beginning at noon on Thursday and all day Friday. Operations will resume as normal on Monday, July 6. Have a great holiday weekend!

Tags: senior market blog, senior market news, Medicare Advantage, Health Insurance, Medicare, Medicare Supplement, Senior Market, Medicare Discussion, Medicare News, senior insurance market news, health insurance news, health insurance industry, Medicare Advantage News, Medicare Advice, CMS

HR 6331: How Will It Affect the Market?

Posted by Nicole Andreas on Wed, Nov 19, 2008 @ 02:18 PM

HR 6331 BillThe Medicare Improvements for Patients and Providers Act, recently approved by Congress in September, has created quite a stir in the insurance market. The new CMS regulations will no doubt have a large impact on the 2009 selling season and the future of Medicare Advantage plans.  Many companies are changing how they structure their Medicare Advantage plans and how agents can market them.  Do you know how these changes will affect you?

  • Government spending on MA reduced by $12.5 Billion
  • PFFS plans required to establish network by 2011
  • Quality reporting requirements for PFFS plans
  • High MA premiums to cover reduction in spending
  • Marketing Reforms- how plans can be marketed and sold
  • Expansion of Part D Low Income Programs
  • Phase out of Indirect Medical Education Payments
  • Growth in Medicare Supplement market

Are you prepared to offer your clients other options to better fit your clients' needs?

Check back frequently to stay educated on updates to the CMS bill and what it means for your business.

Tags: Medicare Advantage, industry news, CMS

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