In article in www.reuters.com, Mark Miller writes about the above-average ratings for all Medicare plans. With special bonuses attached to those plans which provide higher quality service, plans such as Medicare Advantage are catching on – and this means patients can expect to see extra benefits in Medicare in the years to come. Find out more in the article below.
Advantage is a fast-growing privatized insurance option that seniors can select instead of traditional fee-for-service Medicare. Most are health maintenance organizations or preferred provider organizations, and they have grown rapidly in recent years by bundling all-in-one medical and prescription drug services.
The plans get higher reimbursements from Medicare than fee-for-service providers – 14 cents on every dollar before the ACA was passed. The plans are required to use the higher reimbursements to offer lower premiums and extra benefits to seniors.
CMS uses a rigorous system of quantitative measures to evaluate key areas of plan quality, including preventive care, chronic disease management, prescription drug plan management and responsiveness to patients.
Plans can receive up to five stars from CMS, and the ratings are available to seniors shopping for coverage. This year, the Kaiser Family Foundation reports that only 26 percent of the Advantage plans are rated above average or excellent; 59 percent are rated average, and nine percent receive less-than-average scores.
Most of the above-average plans are found on the west and east coasts, according to Kaiser. Not-for-profit Advantage plans tend to get higher ratings than for-profits.
“The large firms are focused much more on quality, now that it’s tied to bonus payments,” says Gretchen Jacobson, policy analyst at Kaiser. “It’s made them pay attention.”
Seniors who enroll in four or five-star plans likely will see more extra benefits in the years ahead. And, while an Advantage plan with Mostmedicare.com will save money for some seniors, it’s important to review the plan’s network of doctors to make sure yours are in the plan. Also pay close attention to the plan’s co-pays, co-insurance, and deductibles for in-network and out-of-network care.
Even though in general recipients can expect to see more benefits in Medicare in the near future, it is still important to make sure you review the reports from CMS, the federal agency that administers Medicare, and choose only those who receive 4 or 5 star ratings.