Nov 16, 2023Liked by Merrill Goozner


If there is no problem, I am going to put much of this over at Angry Bear, an economics blog that has been around a long time.

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Very interesting to pair hospital systems dropping out of MA plans with the STAT exposé on denial-via-algorithm. As to stopping the MA juggernaut, though: I was surprised to read recently, via a study by Lanlan Xiu et al., that MA growth is primarily a result of people switching *into* MA from FFS:

"We found that switching from fee-for-service Medicare to MA more than tripled between 2006 and 2022, whereas switching from MA to fee-for-service Medicare decreased, with the change rates accelerating since 2019. The share of switchers among all new MA enrollees rose from 61 percent in 2011 to 80 percent in 2022."

I fear that the premium difference btwn MA and FFS + Medigap (for those who don't get an employer-sponsored supplement) is just too great for many people to withstand, especially as their resources dwindle. Most MA enrollees pay only the Part B premium, $164/month this year, as opposed to Part B + Part D (say $30-40/month) and Medigap (say $100-200/month). As the STAT indicates, it's all too often "pay now or pay later" (via MA OOP exposure and denied care), but $164 vs. $320/month is a deal that many can't refuse.

Link to the study re MA switching: https://www.healthaffairs.org/doi/10.1377/hlthaff.2023.00224#:~:text=We%20found%20that%20switching%20from,to%2080%20percent%20in%202022.

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Nov 16, 2023·edited Nov 16, 2023

Oregon’s Samaritan Health is hardly dumping MA. They are merely booting UHC. They want to move everyone to their very own MA plan. Why leave capitated money on the table?

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Huh. $334/month for two, right? My wife just started Plan N (UHC) in NJ for ~$120/month, which seemed low to me: I guess it rises with age, as both our parents were paying +/- $200/month. Re the Part D: is it feasible to switch?

I'm kind of surprised that LTC is as low as that: I've assumed there's no feasible pricing for it.

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