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Medicare Advantage Plans: Who Benefits When the Government Pays More? 

Knowledge at Wharton
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KNOWLEDGE AT WHARTON ARCHIVES: When the U.S. government pays more for medical services - as it does for Medicare Advantage - does the quality of those services improve? Not much, says Mark Duggan, a Wharton business economics and public policy professor. That was a key finding that he and co-authors Amanda Starc, a Wharton health care management professor, and Wharton Ph.D. student Boris V. Vabson came to in their recent research paper, “Who Benefits When the Government Pays More? Pass-through in the Medicare Advantage Program.”
In this interview, Duggan explains the study’s findings and some of the policy implications. He notes the increase in competition generated by higher Medicare Advantage payments “doesn’t seem to translate into better benefits for consumers.” The study could have implications for Medicaid, managed care and other government health care spending, Duggan says. It shows there may be many opportunities to cut programs, with minimal adverse impact on consumers, and then use the money saved where it may provide more efficient benefits.
More on this interview: knowledge.wharton.upenn.edu/a...
#medicare #medicareadvantage #healthcare

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3 июл 2024

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Комментарии : 35   
@Percyfaith7
@Percyfaith7 5 лет назад
In the big picture it seems that what would be more helpful to the body and pocketbook health of the nation's insured would be educating folks to eat real quality local season food (vs processed), exercise more, get some sunlight daily, manage stress and sleep better. Health care has little to do with health or care for chronic conditions because business does not heal... the body does and it does it best when people take responsibility for there own health. When nutritional deficiencies are shored up and toxicities are lowered physical health will flourish. Consumers generally pay more for medical care and they get less because the system is approached as a business rather than an honored and gifted ministry. The mental toxicities are greed fueled by our society which is steeped in self centered indulgences, ambition, competition, gluttony and materialism. On a positive note with motivation and education about healthy choices it is possible to live and die well.
@joannelennstrom4934
@joannelennstrom4934 9 лет назад
Washington State's Group Health insurer dropped the 2014 Advantage plans that both my husband and I were on. Now I understand why.My inclination is to not enroll in an Advantage plan now. Medicare is just as good. without it.
@mister-LA
@mister-LA 4 года назад
Excellent video. I wonder if it's time to revisit this study.
@rkbnc154
@rkbnc154 8 лет назад
Medicare Advantage is Insurance that provides a limit to the costs for the patient. The MOOP, Maximum Out of Pocket, limits the patients liability for costs not paid by Original Medicare. My understanding is that there is unlimited liability for medical bills under original medicare, whereas the MOOP with Medicare Advantage limits the patient's liability for unlimited costs to the MOOP.
@Syncopator
@Syncopator 3 года назад
There's this thing called a "supplemental" plan, that original Medicare recipients can add, and won't restrict them to a more limited network of providers.
@malcolmmarzo2461
@malcolmmarzo2461 8 лет назад
Thank you for some clarity on health economics.
@BillyLapTop
@BillyLapTop 9 лет назад
Interesting look into how the sausage is made.
@lightup9
@lightup9 9 лет назад
I enjoyed your talk,but would like to suggest if you do more, speak to the camera. In this video you looked to your right and down all of the time.But it is geared to those concerned about where the money goes and comes from. It is not geared to choosing Advantage over Supplement choices for seniors.
@k.hendrickson8735
@k.hendrickson8735 8 лет назад
+C Summers I agree with you. This guy is like one of my worst professors! He's a genius and really knows the in's and out's of Health Insurance. But the Droning on and on....I'm more lost than before I watched this. :( I believe what's going on with these "Advantage" plans - and also the "Supplement" plans is this: These are your basic, greedy, profit-driven old school Insurance Companies, now with a different hat plus a Groucho Marx plastic nose & glasess, sniffing around seniors on Medicare looking to find a way to squeeze a profit out of them AND the government. ALL Insurance companies are in the business to do one thing: Make A Profit. Not help people. Make. A. Profit.
@mkl01_99
@mkl01_99 4 года назад
So just what benefits to actual health care do health insurance companies provide? Seems like a skimming operation to me.
@kc5658
@kc5658 3 года назад
True. They take close to $100 and provide $50 to consumers and pocket the rest. Why do you think they are spending so much money on advertising? All insurance companies in US is in con job.
@robertsparks7244
@robertsparks7244 Год назад
I called my eye doctor and they take no advantage plans only VSP. They all say vision that may not be true.
@elviedelarosa5028
@elviedelarosa5028 8 лет назад
I retired at age 66 and during that time, Medicare didn't offer anything other than part A and B. Currently, I am spending lots if many on my prescriptions. I am interested to know how I can lower the amount I have been spending on my prescriptions, considering I have a fixed income. thank you for the seminar - looks like there's a lot more I need to know.
@johna.balotawithmedicareli5805
I need to know more specific info to give you a more complete answer. When you become eligible for Medicare, you have more options than just A and B. For example, Medicare Part D will help pay for your prescriptions and lower your out of pocket costs. Another way to lower your cost on your prescriptions is to go to a discount pharmacy like Costco. You don't have to be a member there. You also have the option to purchase Part C medicare or Medicare advantage plan, which will include a prescription plan for no extra cost. Again, you do have options but you need to speak with an independent medicare agent that will not pressure you into any particular plan but will take the time to go over your options and then you decide what is best for you. Hope this helps. You can visit my website at www.medicareline.org and contact me. I will be more than happy to assist you if I can.
@rolandoarellano482
@rolandoarellano482 6 лет назад
Elvi if you still need help with Medicare please email me rarellano.associates @gmail.com
@keithlidlow6910
@keithlidlow6910 9 лет назад
Given the Urban emphasis of increased government subsidies, what part does 'cost of living' play in the allocation of the increased funding? For example, the increased premium could increase the the availability and the quality of the providers who would otherwise be providing services without profit or with marginal profit..
@zjs3532
@zjs3532 8 лет назад
+Keith Lidlow "Urban?" Rural areas receive medicare just as much as urban areas
@jrj90620
@jrj90620 7 лет назад
This guy spent 22 minutes to just keep repeating that govt paying less to insurance companies doesn't change care.So,how did Wharton determine the level of care received by consumers?Why would I care about how much govt is paying or even know how much?Why not tell us which companies give the best care and how Wharton figured out who did a better job.
@edwardkohout3494
@edwardkohout3494 7 лет назад
They didn't. This guy is NOT an insurance agent and has no idea what he's talking about. It's all academic blah blah blah.
@randallprescott8710
@randallprescott8710 9 лет назад
This video is misnamed. It mostly is concerned about numbers of providers entering the market.
@luismarquez7917
@luismarquez7917 4 года назад
In my experience, many good quality physicians do not accept traditional medicare. This is because of the low payment for services as well as regulate how they practice. How do I know? I'm a hospital administrator.
@charlottetrades3367
@charlottetrades3367 4 года назад
Luis Marquez - What you say may be true however 98% of the Physician population accept traditional Medicare and I’m certain quality care can be found in the 98%. Cheers.
@dennishaney4494
@dennishaney4494 9 лет назад
My judgment is still out? Or there's 4 me?Rolling along or hobbling alongtonight.Everyday is different when you have certain medical diagnosis? ??Lol Being Positive about it! What choice do we have in life.W we do what we think is right at the time and never know what the next minute, hour and Tomorrow will bring us!? Dennis
@residentzombie
@residentzombie 7 лет назад
It's easy to guess at what your costs will be with a MA plan due to mostly flat co-pay amounts and you can see if you had had this plan for the past 2 years what your medical costs would have been under the MA plan. For most people MA saves them a lot of premium Dollars versus supplements and is the best option for relatively healthy seniors especially those on a fixed income. There is a strong divide in the agent community however over MA plans but most of agents who bad mouth these plans do so due to the horrendous CMS regulations over selling these products and the lower commission than if a supplement was sold. MA pays an agent $300 year 1 and $200 every year afterwards whereas a supplement averages about $280 per year for each year.
@PHanomaly
@PHanomaly 7 лет назад
Bottom line: Private Insurers are the ones benefiting from providing Medicare benefits, not consumers. I switched to a MA plan this year, and can't wait to switch back to Original Medicare. I can't get an intelligent answer to anything on my plan, and the ways they do things make me suspicious that its more of a 'bait and switch'. I definitely feel like I'm getting less on an MA plan.
@yewkiamakuahui2296
@yewkiamakuahui2296 4 года назад
This is two years later. Are you still happy going back to Original Medicare? Did you have any big medical issues that incur high medical costs? I think it is a mistake to revert back to Original Medicare. Either your MA (Advantage plan) or a Supplement plan would limit the Max out of pocket cost to you, thereby giving you some security.
@yewkiamakuahui2296
@yewkiamakuahui2296 4 года назад
@Cynthia Murphy .. please talk to a SHIP agent or an insurance agent. I am concerned with the out of pocket costs if you get into a medical issue that requires a lot of medical care. Original Medicare does not limit your out of pocket costs, so that can go to the sky if you are not lucky.
@kc5658
@kc5658 3 года назад
Super. Why should we encourage private insurance to get fatter at our expenses? Just stay with medicare A, B and may take D. I am not going to be in hospital for more than 60 days in an year- so they scar you unnecessarily
@Syncopator
@Syncopator 3 года назад
@@kc5658 Supplemental plans with Original Medicare plus a D plan seem to be the best IMHO-- not the cheapest, but you get what you pay for. There are a lot of horror stories about MA insurers limiting what care they will cover, not paying for cancer treatments as often as your doctor thinks you need, etc., so if you have something serious you may have more out of pocket or you have to do without. And of course, many have a limited network of providers and require pre-approvals of procedures. I would wonder what a doctor who takes both Original Medicare and is in a MA network thinks about the two regarding what they cover and what they don't...
@iangray906
@iangray906 9 лет назад
My illness is mental I hope to get as good as NHS healcare if not I'll go in to political science and then we will have a great empire state university is what I'm doing sick
@marygao4517
@marygao4517 4 года назад
Professor, you do not really know healthcare. When you compare MA and original medicare's out come, did not consider MOOP? Your search is misleading and not fair to people 65+.
@barbt.9211
@barbt.9211 2 года назад
What the hell are you talking about cut the bs and help the sick people, This is all about MONEY and not helping the sick, it's disgusting.
@edwardkohout3494
@edwardkohout3494 7 лет назад
This guy has NEVER sold a stick of insurance in his life!!! Talk about what people NEED. Talk about how real people are struggling to live on a fixed monthly SSA check. The MA program is GREAT for a lot of low income and poor people. The quality of care is the SAME. Don't scare people !!!!
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