Senate Dems Criticize ‘Excessive’ Medigap Price Hikes; ACOs Examined

The Hill: “Top Senate Democrats on Wednesday called on the Department of Health and Human Services (HHS) to protect seniors in Medigap plans from ‘excessive’ rate hikes. … The lawmakers cited some Medigap plans offered by United of Omaha, which will see premiums increases around 40 percent next year. … They’re calling on HHS to ‘work with Governors and State Insurance Commissioners to help them gain this authority [to monitor rate changes] where it does not exist today'” (Lillis, 10/6).

CQ HealthBeat: “Majority Leader Harry Reid of Nevada, Max Baucus of Montana and John Kerry of Massachusetts wrote to Sebelius Wednesday. Seniors purchase the supplemental insurance plans from private insurers to cover a number of things that traditional Medicare either does not cover or does not cover fully. … The lawmakers also requested that HHS study Medigap trends and costs to provide a benchmark against which future rate increases could be measured. Seniors often opt to get supplemental coverage through the cheaper Medicare Advantage program rather than Medigap” (Ethridge, 10/6).

Meanwhile, WBUR reports on Accountable Care Organizations: “ACOs are hot. They were the topic of a major federal meeting yesterday. Today they are on the agenda of the Massachusetts panel that’s charged with revamping the health care payment system. Another state panel has already recommended heading toward them. They are causing many concerns. Your health care organization may try to become one. So what are they?” WBUR links to a video that explains ACOs, which are designed to coordinate patient care among physicians and hospitals. The piece notes that if ACOs fail to meet quality and cost targets, they would receive less money from Medicare (Goldberg, 10/6).

The Kalamazoo Gazette: “Some senior citizens and others enrolled in two of Blue Cross Blue Shield of Michigan’s Medicare Advantage plans will have to make a switch before the end of the year. ‘What’s happening is that those plans, nationally, are ending,’ said Blue Cross Blue Shield of Michigan spokeswoman Helen Stojic. The plans are ‘sunsetting (being phased out) because they don’t have provider networks,’ she said. … In their place, Blue Cross Blue Shield is offering an array of products that have service provider networks, she said… Stojic said she did not know how many of Blue Cross’ 4 million members statewide are affected” (Jones, 10/6).

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