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Despite all of the positive improvements to our current healthcare system contained in the final healthcare reform package, the bill significantly reduced funding for Medicare Advantage recipients. What that means is that health plans will eventually reduce Medicare Advantage benefits and increase consumer premiums to a point that the comprehensive and affordable benefits offered through Medicare Advantage will look no different than benefits offered by traditional Medicare. Medicare Advantage is the best example of coordinated, accountable care in the country and the decision by Congress to cut this program was extremely shortsighted, especially in light of their widespread support of ACOs.

As our national leaders work to implement healthcare reform throughout the nation, it's essential that physician-driven Accountable Care Organizations are expanded and the coordinated care model offered through Medicare Advantage is duplicated. Consider the following facts:

In 2007, Medicare Advantage saved seniors nearly $90 per month or $1000 per year in out of pocket costs. An estimated savings of approximately $7 billion annually.¹

[1] Atherly, A, and Thorpe. KE, The Impact of Reductions in Medicare Advantage Funding on Beneficiaries. Atlanta, GA: Emory University Rollins School of Public Health, 2007.
Atherly, A, and Thorpe. KE, Value of Medicare Advantage to Low-Income and Minority Medicare Beneficiaries. Atlanta, GA: Emory University Rollins School of Public Health, 2005. Presentation by Abby L. Block, Director, Center for Beneficiary Choices, Centers for Medicare & Medicaid Services, before the National Medicare Education Panel, October 24, 2007.

Additionally, compared to traditional Medicare, Medicare Advantage plans can reduce out-of-pocket costs by up to $4,000 annually for patients with the highest healthcare needs.²

[2] “The Value of Extra Benefits Offered by Medicare Advantage Plans in 2006” Prepared by Mark Merlis for the Kaiser Family Foundation, January, 2008.

• Comprehensive Care: Patients receive integrated treatment plans, and expert case management and disease prevention strategies for the chronically ill.
• Cost-Effective Care: Integrated medical groups are able to support investments in advanced healthcare information technology, tracking patient follow-through on treatment plans and patient outcomes, and helping to uncover health problems before they become catastrophic.
• Accessible Care: Efficiencies within the coordinated care delivery model mean better healthcare for more seniors, including:
  • lower out-of-pocket costs
  • increased health services such as dental care, vision care and preventive care
  • reduced hospitalizations
  • increased prescription coverage
  • higher overall satisfaction rates
  • greater value for the premium dollar than any other healthcare delivery system
  
• Low Income Care: Medicare enrollees are more likely to have limited means (i.e., incomes under $20,000 to $30,000), are much less likely to have employer-provided supplemental coverage, and more likely to be racial and ethnic minorities.³

  [3] Atherly, A, and Thorpe. KE, Value of Medicare Advantage to Low-Income and Minority Medicare Beneficiaries. Atlanta, GA: Emory University Rollins School of Public Health, 2005.

• Lower out-of-pocket costs: More efficient care through Medicare Advantage adds up to savings for patients — on average, out-of-pocket costs are nearly $90 a month less than traditional fee-for-service Medicare. That’s more than $1000 a year in savings⁴

  [4] Atherly, A, and Thorpe. KE, The Impact of Reductions in Medicare Advantage Funding on Beneficiaries. Atlanta, GA: Emory University Rollins School of Public Health, 2007.
  Atherly, A, and Thorpe. KE, Value of Medicare Advantage to Low-Income and Minority Medicare Beneficiaries. Atlanta, GA: Emory University Rollins School of Public Health, 2005.
  Presentation by Abby L. Block, Director, Center for Beneficiary Choices, Centers for Medicare & Medicaid Services, before the National Medicare Education Panel, October 24, 2007.

• Cost Efficiencies: Compared to traditional Medicare, Medicare Advantage plans can reduce out-of-pocket costs by up to $4,000 annually for patients with the highest healthcare needs.⁵

  [5] “The Value of Extra Benefits Offered by Medicare Advantage Plans in 2006”. Prepared by Mark Merlis for the Kaiser Family Foundation (January 2008)

Downloadable Resources

High-Performing Health Care Organization Case Study

California Association of Physician Groups Report: From the Point of Care - The Experience of California Physicians in the Medicare Advantage and Traditional Medicare Programs

The Organized Health Care Delivery System

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