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MANAGEMENT UPDATE.

STATES MAY SAVE MONEY ON MEDICARE, BUT AT WHAT COST?

According to a recent brief from the Kaiser Family Foundation, a dozen states require retirees who receive state retiree health benefits to enroll in Medicare Advantage Plans, while nearly all offer these plans as an option. 


Medicare Advantage Plans, as KFF explains “are private plans – such as PPOs or HMOs – that provide all Medicare-covered benefits, typically include extra benefits such as dental, vision, hearing, and Part D drug coverage, and often provide all benefits for no additional premium (other than the Part B premium).”


Since Advantage plans tend to be cheaper than traditional alternatives, which make them attractive to states concerned about health care costs (which is practically all of them), there are distinct tradeoffs here. As KFF wrote, “In addition to often having a more limited network of providers, Medicare Advantage plans typically employ utilization management tools, such as prior authorization. These limitations are, in part, why public sector retirees in both Delaware and New York City sued to stop being moved into a Medicare Advantage plan.


A recent piece in Fortune by the well-known expert on issues of aging, Richard Eisenberg, elaborated by quoting Paul Ginsburg, a University of Southern California professor of health policy, as saying, “Hospitals are becoming increasingly frustrated about prior authorization and claim denials, saying they won’t contract with a Medicare Advantage plan.”


In fact, reports Eisenberg, “In some rural areas, few or zero doctors and hospitals participate in Medicare Advantage plans that companies and government employers offer retirees.”


Yet one more disadvantage of the now mandated Medicare Advantage plans, according to Eisenberg, “If you later decide you want to replace Medicare Advantage with traditional Medicare—forgoing your retiree health benefit subsidies—you might be unable to get a Medigap plan.”


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MANAGEMENT UPDATE ARCHIVES.

VOICES FROM THE GFOA EPISODE 2

VOICES FROM THE GFOA EPISODE 1

SAN FRANCISCO STANDS ALONE AND NOT IN A GOOD WAY

HOW YOUR CITY CAN IMPROVE ITS DATA USE

PREPPING FOR NEW OVERTIME RULES

BUDGET GAMES TO PAY FOR EDUCATION

THE SAD STATE OF ILLINOIS BOARDS AND COMMISSIONS

RETAINING POLICE AND FIREFIGHTERS WITH PENSIONS

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