Medicare Pilot: Pay For Quality Or Wasteful Political Ploy?

By  //  April 26, 2012

Healthcare Policy

Medicare Advantage Pilot Project: Pay For Quality Or Wasteful Political Ploy?

EDITOR’S NOTE:  One quarter into what may be the most pivotal election year in American history, the partisan rhetoric and spin is rampant.  SpaceCoastDaily is committed to providing a voice of reason, fairness and common sense for you, our readers and viewers, as well as a forum for you to share your opinion with the community.

With the rescue of our economy still the number one and most controversial issue of the campaign, negotiation over and proposed policy related to healthcare, the debt ceiling, the deficit and taxes, and posturing on the part of both political parties to cast themselves in the best light for the 2012 elections will continue unabated until election day and beyond.

Over the course of this election year, we will be focused on assuring that you have the opportunity to hear from both sides of the aisle on all of the key issues.  We’ll provide facts and commentary from trusted journalistic sources across the country, plus input from local experts and the community at large, so that you are optimally informed on all of the decisive elements of each issue and prepared to cast confident votes in November.

That having been said, I am excerpting an Associated Press article from earlier this week by Ricardo Alonzo-Zalvidar, which calls into question the Obama administration’s portrayal of the impact their fiscal management and  policies have on Medicare Advantage (MA), a popular private insurance alternative to traditional Medicare.  MA coverage is offered by more than 3,000 private plans and serves nearly 12 million beneficiaries, of which approximately 40,000 live in Brevard County.

Reports directly related to the future of MA programs were released last week by two different government agencies. According to the Center for Medicare and Medicaid (CMS) report, “The Affordable Care Act: Lowering Medicare Costs by Improving Care,” lowering excessive Medicare payments to private insurers in Medicare Advantage should save about $68 billion over the next four years.

Although President Obama has, at least for now while the Supreme Court deliberates over the constitutionality of the healthcare reform law, limited his personal campaign references related to the Affordable Care Act, his administration continues to highlight the “good stewardship” of the Medicare program that is baked into the law.

However, federal investigators at the Government Accountability Office (GAO), the nonpartisan investigative arm of Congress, reported last week that Medicare is wasting more than $8 billion on a pilot program that was designed to pay bonuses to health insurance companies caring for millions of Medicare Advantage beneficiaries based on the quality of care delivered.  The GAO found that bonuses were consistently being paid out for mediocre care and that the pilot program was unlikely to produce useful results.

Despite the report and recommendation from the GAO, the administration has defended the project and takes the position that it could improve quality of care for seniors enrolled in the MA plans.

With the prospect of significant MA plan payment cuts scheduled to take effect next year after the election, the question and concern that is being raised on the other side of the aisle is whether or not the President and his administration are using a very costly and ineffective pilot project to appease the 12 million seniors, a formidable block of swing voters presently enrolled in and very satisfied with their MA plans, during the course of the next seven months before the election.

We report and welcome your comments. YOU decide.

WASHINGTON (AP) — In a blow to the Obama administration on Medicare, government auditors Monday called for the cancellation of a costly bonus program for private health plans that congressional Republicans have criticized as a wasteful political ploy.

The nonpartisan Government Accountability Office said it’s not clear that the $8.3 billion Medicare Advantage bonus program will improve quality because most of the money is going to plans just rated average. The auditors did find, however, that the bonuses would temporarily ease the pain of unpopular cuts to insurance plans under President Barack Obama’s health care overhaul law.

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