Medicare Plans' Cost

By Jay Cohen / New York Times
Saturday, December 6, 2008

While your points are thoughtful and persuasive, there is more to the issue that may be of interest to your readers and policy makers.

As chairman of the California Association of Physician Groups (California's largest physician organization comprises more than 150 of leading physician groups employing or contracting with more than 59,000 physicians), I believe it is imperative to point out that the Medicare Advantage ''private fee for service'' program is the main culprit of these costs.

Read the full story at the New York Times.

Coordinated Care 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. 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.

  • 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

What’s At Risk

If Medicare reforms dismantle incentives for coordinated care, seniors will experience significant increases in out of pocket costs - at a time when many seniors have seen their retirement account’s decline by over 40 percent in value — and decreased quality of healthcare.

Downloadable Resources

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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