A Provider magazine article entitled “Medicare Advantage Marketplace Snapshot Offers Clues to Providers” provides a detailed overview of the Leavitt Partners “Medicare Advantage Premiums Higher in Markets with Concentrated Health Plans” white paper. The article states, “Amid moves by some long term and post-acute care (LT/PAC) providers to expand into health insurance through the marketing of Medicare Advantage (MA) plans to residents, a new report by Leavitt Partners offers a glimpse of how the MA marketplace functions, and how the lack of real competition impacts consumers. This insight may give interested providers a deeper view of the opportunities and challenges the increasingly popular MA trade offers.”
A Chicago Tribune article entitled “Bush administration alums rising in Trump’s orbit” includes commentary from Governor Leavitt regarding the Trump administration hiring staff who previously served in the Bush administration. “These are complex jobs and the time is limited,” said Governor Leavitt. “If everyone has to learn it anew the chances of implementing an agenda are substantially reduced and the quality of government isn’t as good.”
A FierceHealthcare article entitled “Study: Medicare Advantage premiums higher in markets with less payer, hospital competition” highlights the Leavitt Partners “Medicare Advantage Premiums Higher in Markets with Concentrated Health Plans” white paper. The article references a few of the key findings and states, “Given these findings, researchers said policies that encourage competition, monitor current levels of competition and deter decreases in competition may help avoid future premium increases for MA beneficiaries.”
As health care costs continue to consume an increasingly large share of the federal budget and impact Americans’ personal finances, it is important to understand the various drivers of those costs. The literature documents how higher levels of concentration (lack of competition) among commercial payers and providers contributes to higher premiums for commercial health plans. Less well understood, however, is the relationship between the concentration of Medicare Advantage (MA) plans in a market and MA premiums. Our paper uses a fixed-effects, multivariate regression to evaluate the association of both MA plan concentration and health system concentration on MA premiums. We found that increased concentration (lower competition) in the MA insurance market was associated with higher MA premiums and that if all beneficiaries were in markets at least as competitive as the average market today, they would pay nearly $200 million less in annual premiums. We also found that the highest premiums were in markets that lacked competition among MA payers and hospital markets, suggesting the interaction between MA insurer concentration and hospital system concentration matters. Our findings suggest that maintaining or increasing current levels of competition is necessary for controlling MA premiums.
Salt Lake City, November 15, 2017 – With Medicare Advantage open enrollment period already underway, it is important to examine the Medicare Advantage premiums paid by beneficiaries. Today, Leavitt Partners released, “Medicare Advantage Premiums Higher in Markets with Concentrated Health Plans,” a white paper that examines the relationship between the concentration (a measure of market competition) of Medicare Advantage plans and the out-of-pocket costs to beneficiaries, as well as the association between health system concentration and Medicare Advantage premiums.
Leavitt Partners “Growth Of ACOs And Alternative Payment Models In 2017” Health Affairs Blog was referenced in a RevCycleIntelligence article entitled “29% of Healthcare Payments Under Alternative Payment Models.” The article states, “Ninety-two new organizations started operating as ACOs in 2016, bringing the total number of ACOs to 923 nationwide by the start of 2017, a recent Leavitt Partners and Accountable Care Learning Collaborative analysis stated.”
David Muhlestein was interviewed for a Modern Healthcare article entitled “CMS loses money as Medicare ACOs remain risk-averse” examining the most recent federal data on the CMS Medicare Shared Savings Program (MSSP). “If everyone were at risk, it would have been a profitable year (for the CMS),” David said. He also noted that a $39 million loss (just 0.05 percent of the costs) is quite low for Medicare.
An American Journal of Managed Care article entitled “Navigating the Politics of the Healthcare Landscape” provides a recap of Clay Alspach’s remarks at the ACO & Emerging Healthcare Delivery Coalition® Meeting on October 27. Clay addressed the current status of the ACA repeal and replace efforts, expiring health programs, and drug pricing and importation. “The rule of the past 12 months has been to prepare and expect the unexpected,” Clay said.
In an HFMA article entitled “In the Wake of Hurricanes, Hospitals Should Revisit Their Emergency Preparedness Plans,” Lia Winfield discusses seven key points hospitals should address as they revisit their hospital emergency plans: self-sufficiency, communication, reputation, staff, leadership, finances, and mental health. Lia aggregated the key takeaways from governmental and academic reports. She also cites Governor Leavitt’s previous pandemic and emergency preparedness publications.
David Muhlestein commented on the most recent Shared Savings and Pioneer ACO model results for a Bloomberg BNA article entitled “Coordinated Care Models Save Medicare Big Bucks.” “Hospitals and physicians are continuing to join these models as they realize health care will eventually be paid on value-based payments,” David said. “Many ACOs are just starting to get used to the programs, therefore earning more savings”. The commentary was also referenced in a McKnight’s Long-term Care News article entitled “ACOs saved Medicare more than $700 million in 2016”.
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