Famed Florida Retirement Community, The Villages, is Being Fed Medicare Advantage Propaganda
These days, much of what passes for health journalism reads like press releases rather than objective and thorough reporting. In this atmosphere, Medicare Advantage plans are presented in glowing terms without addressing their drawbacks and alternatives or informing seniors of the significant problems the plans can create.
One such story turned up in early May in The Villages Daily Sun, with the ominous headline, “Inside the assault on Medicare Advantage: White House cuts to the popular health plan raise prices and risk benefits for seniors.” Perhaps it was designed to scare residents of Florida’s Villages, the well-known complex for seniors who have flocked down South. It’s a good bet many have Advantage plans given how those plans have saturated the state. It’s also a good bet many residents may struggle to get their Advantage health plans to pay some of their bills when they are sick. In a study released two years ago, the federal Office of the Inspector General found services under MA plans were delayed or denied even though the requests met Medicare’s coverage rules.
The story in The Villages Daily Sun didn’t get into that, however. It touted the virtues of MA plans and downplayed traditional Medicare, writing that last year Medicare “changed the rules with the stated goal of reducing funding for MA plans to force them to reduce benefits.” The story said the rule “removes funding for many diagnoses that will have significant negative impacts on doctors caring for MA patients,” and “includes removing funding to pay for preventing vascular disease complications before they occur.” There was more alarming news: There would be a “.16% cut in MA reimbursements for insurers starting Jan. 1.” The cut, the writer noted, could “translate to a $33 reduction in benefits monthly for 2.8 million Florida seniors who have MA plans,” adding that companies may be “hinting at higher patient costs and reduced benefits when they announce 2025 benefits.”
Many Medicare experts believe that Advantage plans have long been overpaid by the government, which at last is now taking small steps to slow down what has amounted to a proverbial gravy train for the plans. As I reported in my last post, “The press is beginning to take notice of how health insurers are raiding the Medicare trust fund.” That story noted that MA plans are driving up the cost of Medicare by 22%. That kind of information usually doesn’t make it into stories like the one published in The Villages newspaper.
That story did, however, note that critics say Advantage plans are “reimbursed too much and deny care too frequently.” It reported that they are paid more than traditional Medicare because the program’s risk adjustment system is “not working very well.” How many residents are likely to understand that actuarial concept, which needed more explanation and perhaps an example or two?
An academic at the University of Miami Herbert Business School told the reporter there would be more “push-back on costs.” Humana, which earns 80% of its revenue from Medicare, said it will cut some benefits next year and terminate some plans. Cigna is exploring the sale of its Medicare Advantage business altogether, and UnitedHealthcare cut back on some Advantage services and ended some plans. CVS/Aetna has told investors it will also leave some markets and reduce benefits next year.
The story also describes the experiences of counselors helping seniors who are understandably confused about their Medicare options. It reads more like a plug for Medicare Advantage than an objective presentation of the options. The principal/owner of an area financial corporation says when seniors come to his office for Medicare help, they are “generally stressed,” and that the conversation shifts more to Medicare Advantage. “The Advantage options are so strong in our area and in our market that it is a natural fit for most people in the area,” he says. Unnamed officials, presumably at The Villages health care facilities, say “the cuts drop directly to operations,” implying that less reimbursement from the government could slow down plans to add new specialty positions at The Villages Health and expand services, such as weekend clinical hours.
And, patients with traditional Medicare who are seen at specialty care centers will have to be moved “to the bottom of the list” of new patients, according to Dr. Jeffrey Lowenkron, chief medical officer at The Villages Health. Will they even get care in Lowenkron’s clinic? That’s not clear. The doctor told The Villages Daily Sun the clinic made a “service commitment to our MA patients that we are going to live up to. These cuts most heavily impact residents who are middle class, on fixed incomes and low-income, and we’re not going to break our promise to them.”
That is probably enough to make The Villages residents still in traditional Medicare sign up for Medicare Advantage as soon as they hear the first pitch this fall.
It’s worth sharing again an email I received a few months ago from another Floridian, 81-year-old David Marans, who recognized the pitfalls in Medicare Advantage plans and has traditional Medicare with a supplement. He said he just shows his card at any hospital or doctor’s office, no questions asked, and the Medigap provider takes care of the rest. “Force yourself to get a Medigap plan on your 65th birthday when you first enroll in Medicare and don’t lose it,” he said. “Seniors have to understand car insurance is for what might happen. Health insurance is for what very probably will happen.”
Editor’s note: The story is no longer on The Villages Daily Sun’s website.
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Couldn't happen to be a better group of people. Maybe this will help them to see that supporting a fascist isn't the best way forward.
I have traditional Medicare and a supplement plan. I have never been denied care, but I have seen patients turned away because they have a Medicare Advantage plan.
This is just plain wrong, and that is why we need a universal healthcare plan for everyone !