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October Plan Management Navigator
By Douglas B. Sherlock; MBA, CFA
Please find attached the October 2009 edition of our Plan Management Navigator.
Medicare-Orientated Universe
In this month’s edition, we update ME-P and all readers on the results for the Medicare-Oriented universe, and provide summary functional area breakouts as well as expense trends. Holding constant the universe, and the product mix offered, administrative expense growth was higher than last year.
For example, eleven Medicare-Oriented plans serving 1.1 million beneficiaries participated in this year’s benchmarking study. In addition, the results from Blue Cross Blue Shield Plans and Independent / Provider-Sponsored Plans are also summarized. With these additional plans, we provide selected information on health plans serving 2.1 million Medicare beneficiaries, comprising approximately 22% of Medicare Advantage members during 2008.
Assessment
The analysis is based on materials from our Sherlock Expense Evaluation Report (SEER) for the Medicare-Oriented Plans. Additional information about SEER is available at www.sherlockco.com/seer.shtml or by contacting me.
Link: Navigator 10-09
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Filed under: Breaking News, Health Economics, Monthly Reports, Research & Development | Tagged: Blue Cross Blue Shield Plans, Douglas B. Sherlock, Medicare Advantage, Plan Management Navigator, SEER, Sherlock Expense Evaluation Report, www.Sherlockco.com |
The Leading Business Education Network for Doctors, Financial Advisors and Health Industry Consultants 
The Centers for Medicare & Medicaid Services (CMS) is listening and wants to hear from you about the services provided by your Medicare Fee-for-Service (FFS) contractor that processes and pays your Medicare claims. CMS is preparing to conduct the fifth annual Medicare Contractor Provider Satisfaction Survey (MCPSS).
This survey offers Medicare FFS providers and suppliers an opportunity to give CMS feedback on their interactions with Medicare FFS contractors related to seven key business functions: Provider Inquiries, Provider Outreach & Education, Claims Processing, Appeals, Provider Enrollment, Medical Review, and Provider Audit & Reimbursement.
The survey will be sent to a random sample of approximately 30,000 Medicare FFS providers and suppliers. Those who are selected to participate in the 2010 MCPSS will be notified starting in January.
If you are selected to participate, please take a few minutes to complete this important survey. Providers and suppliers can complete the survey on the Internet via a secure website or by mail, fax, or telephone.
To learn more about the MCPSS, please visit cms.hhs.gov/MCPSS on the CMS website.
Source: Dr. Paul Kesselman, Woodside, NY
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Medicare Pay Board Would be Repealed Under GOP Bill
A group of key Republican senators have introduced a bill that would repeal the Medicare Independent Payment Advisory Board, a new federal panel created by the health system reform law whose mission will be to propose how to extend the program’s solvency. Several physician organizations, including the American Medical Association, have been opposed to the Medicare pay board. They say it could lead to yet another level of mandated cuts to doctor pay on top of any rate reductions that are already required by the Medicare statute.
The opponents of the new board said passage of their bill, the “Health Care Bureaucrats Elimination Act,” ultimately will protect seniors’ rights. Sen. John Cornyn (R-TX) on July 27 introduced the legislation, which is co-sponsored by Sens. Orrin Hatch (R-UT), Jon Kyl (R-AZ), Pat Roberts (R-KS), and Tom Coburn, MD (R-OK).
Source: Chris Silva, AMNews [8/9/10]
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