Wednesday, March 3, 2021

Very Brief Blog: Medicare Advantage Proportion by State

Kaiser Family Foundation (KFF) runs a detailed website of CMS data, one aspect of which is Proportion by State in Medicare Advantage.   The website is here.  They provide a lookup table by year, the most recent year is 2018.  Overall Medicare Advantage was 34%, but was ~40% or higher in 8 states.  The peak state was 56% in Minnesota.  Florida, California, and New York all clock in around 40%.

Overall, in round numbers, about 1 in 5 Americans is over 65 and in Medicare.

GEO Model Would Chip Further at FFS Population

I find this next topic quite confusing, but Medicare has proposed a GEO demo model that would seemingly sweep up fee for service beneficiaries in selected zones and put them in a sort of Medicare Advantage plan (Commonwealth Fund here).   

The GEO contractor for those zip codes would pay claims but could also impose medical management rules, have preferred provider networks with better copays, etc.   CMS web page here with new header commenting "GEO is under review" (e.g. from Biden administration).  Fact sheet here.  Dark Daily report here.  Article "CMS pushes pause" here.

Tempest in a Teacup: AHIP vs MEDPAC on Med Adv Spending

On February 26, 2021, AHIP released an online article criticizing MedPAC numbers showing high Medicare Advantage spending - here.   A few days later, on March 3, MedPAC responding with a counter-article, here.