In response to a letter from Senators Reid, Baucus, and Kerry, 1 the Office of the Assistant Secretary for Planning and Evaluation of the U.S. Department of Health and Human Services has prepared this report. The report describes the market in Medigap insurance (also known Medicare Supplemental Health Insurance policies), analyzes trends in Medig
Estimated Savings of $5,000 to Each Medicare Beneficiary from Enactment Through 2022 Under the Affordable Care Act. Methods
This memo was prepared by analysts in the Office of the Assistant Secretary for Planning and Evaluation (ASPE) in consultation with the Office of the Actuary (OACT) of the Centers for Medicare & Medicaid Services (CMS).
Estimated Savings of $5,000 to Each Medicare Beneficiary from Enactment Through 2022 Under the Affordable Care Act. Summary
The Affordable Care Act, enacted in 2010, makes many changes to strengthen Medicare and provide better benefits to seniors, while slowing cost growth. As a result, average Medicare beneficiary savings in traditional Medicare will be approximately $5,000 over the 2010 to 2022 period (see Table 1). Beneficiaries who have high prescription drug spend
Estimated Savings of $5,000 to Each Medicare Beneficiary from Enactment Through 2022 Under the Affordable Care Act
This report provides estimates of Medicare Parts A, B, and D savings from the Affordable Care Act to seniors and people living with disabilities enrolled in traditional Medicare. The Affordable Care Act will favorably affect beneficiary expenditures in four ways: lowering part B premiums growth, lowering beneficiary copayments and coinsurance grow
In order to make good on the original rationale for including private plans in Medicare, the Medicare Advantage program needs to continue improving quality, while lowering costs. The early experience following the enactment of the Affordable Care Act indicates that the MA program is moving in the right direction – beneficiaries have a robust cho
Our goal is to continue improving the MA program while keeping costs down, reducing fraud and abuse, and fostering competition. As discussed earlier, the changes that are underway under the Affordable Care Act reduce higher payments to MA plans, by transitioning to FFS-based payment rates; and provide incentives for quality improvements by basing
The Medicare Advantage Program in 2014. Since the Affordable Care Act: Health Insurance Company Revenues Have Increased
Analysis of data for several large publicly-traded insurance companies that participate in the MA program reveals that these insurers’ total revenues have increased by 29 percent since the enactment of the Affordable Care Act in 2010 (from $275 billion to $355 billion), and their combined operating profits have increased by 13 percent (from $20
The Medicare Advantage Program in 2014. Since the Affordable Care Act: Medicare Advantage Premiums Have Fallen and Benefits Have Remained Stable
Medicare Advantage plans have responded to the Affordable Care Act incentives by becoming more competitive for enrollment by reducing or holding steady their beneficiary premiums; MA plans have not responded with an increase in beneficiary premiums. Figure 3 shows that since the passage of the Affordable Care Act, average MA premiums are down by 1
The Medicare Advantage Program in 2014. Since the Affordable Care Act: There Have Been Substantial Improvements in Medicare Advantage Quality
The Affordable Care Act requires CMS to make Quality Bonus Payments (QBPs) to MA organizations that achieve at least four stars in a five-star quality rating system. The QBP demonstration finalized in the CMS 2012 Call Letter is testing whether providing scaled bonuses to MA organizations with three or more stars will lead to more rapid and larger
The Medicare Advantage Program in 2014. Since the Affordable Care Act: Medicare Advantage Plan Availability Remains High
Table 2 shows that MA plan availability has been stable since the enactment of the Affordable Care Act, with most Medicare beneficiaries having access to at least one MA plan. Plan participation continues to be robust, with nearly all (99.1 percent) 27 of beneficiaries having access to an MA plan in their area in 2014. Additionally, the number of
The Medicare Advantage Program in 2014. Since the Affordable Care Act: Medicare Advantage Enrollment Has Increased By Over 30 Percent
As discussed earlier, since the Affordable Care Act was enacted, actual MA enrollment has exceeded previous projections. 24 Figure 1 and Figure 2 show that Medicare Advantage enrollment and penetration are at an all-time high. Nationwide, approximately 15 million Medicare beneficiaries 25 are now enrolled in an MA plan, which represents nearly 3
The Medicare Advantage Program in 2014. Since the Affordable Care Act: Medicare Advantage Higher Payments Have Decreased
Table 1 shows that the transition to FFS-based rates under the Affordable Care Act, which began in 2012 and is scheduled to end in 2017, has already begun to reduce payments to MA plans relative to fee-for-service Medicare. Moreover, MA plan bids have declined from slightly higher (101 to 102 percent) to slightly less (96 to 98 percent) than fee-f
The Medicare Advantage Program in 2014. III. The Impact of the Affordable Care Act on the Medicare Advantage Program
Prior to the enactment of the Affordable Care Act, concerns were raised about how the transition of MA plan payments to the FFS-based rates provided for in the Affordable Care Act would affect plan participation, enrollment, premiums and benefits.
The private plan option has been available in Medicare for over 30 years; it has grown considerably over that period from representing a small part of the program to accounting for nearly 30 percent of all enrollment today. 2 Medicare Advantage (MA) is the name of the current program that allows beneficiaries to enroll in private health plans, ra
There has been considerable interest in the impact of the Affordable Care Act 1 on the Medicare Advantage (MA) program. This paper provides an overview of pre-Affordable Care Act and post-Affordable Care Act trends in Medicare spending, plan premiums, beneficiary choice of plans, and quality in the MA program. The paper starts with a review of pr
Private insurance plans were introduced into the Medicare program in the 1980s based on the theory that private plans could provide coordinated, high-quality care, and enhanced benefits for beneficiaries at a cost below that of the traditional fee-for-service (FFS) program. Under this scenario, beneficiaries would have a choice of plans from which
Performance Improvement 2011-2012. How Are Market Forces Operating in the Medicare Advantage Program?
Researchers constructed a multi-year analysis file containing data on plan participation, enrollment, disenrollment, benefit design, quality, and county characteristics.
Performance Improvement 2011-2012. What Types of Contracting are States Engaged in with Medicare Advantage Special Needs Plans? - Further Questions
The second report provides a more in-depth look at five contracts between Medicare Advantage SNPs and state Medicaid programs. The five featured programs were selected as examples of types of contracts currently being used by states and SNPs.
Performance Improvement 2011-2012. What Types of Contracting are States Engaged in with Medicare Advantage Special Needs Plans?
The first report provides information on the extent and nature of state contracts with Medicare Advantage Special Needs Plans (SNPs). Review of SNP applications revealed the number of states that are already contracting with SNPs but highlighted a number of policy issues related to how states contract with SNPs.