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Sunday, June 8, 2014

Warning on private medical care options

Posted By on Sun, Jun 8, 2014 at 7:53 AM

A reader calls attention to a good post on Daily Kos  about Medicare Advantage, the private option version of the demonstrably more efficient government-run Medicare program. It repeats what news articles have already noted:

 There are some very good reasons Medicare Advantage was the target for cuts in Obamacare—it has always spent a great deal more per patient than traditional Medicare, even though it has a generally healthier patient base. But, according to a year-long investigation by the Center for Public Integrity, Medicare Advantage plans bilked the taxpayers $70 billion in 2008-13 by exaggerating how sick their patients were.

The "risk scores" that allowed higher reimbursement for sicker patients seem to have been a pathway to abuse. Imagine that providers would game the system to increase profits. 

Hold on, the Arkansas-relevant information is coming (emphasis supplied):

Risk scores of Medicare Advantage patients rose sharply in plans in at least 1,000 counties nationwide between 2007 and 2011, boosting taxpayer costs by more than $36 billion over estimated costs for caring for patients in standard Medicare.

In more than 200 of these counties, the cost of some Medicare Advantage plans was at least 25 percent higher than the cost of providing standard Medicare coverage. The wide swing in costs was most evident in five states: South Dakota, New Mexico, Colorado, Texas and Arkansas.

Let us hope that the private option version of Medicaid expansion — Arkansas's adaptation of Obamcare — doesn't produce similar outcomes.

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