It sounded a little bit like CMS was taking a victory lap — perhaps deservedly — when it unveiled on Sept. 19 the summary premium and cost-sharing results from the Medicare Advantage bidding process for 2013. Average MA premiums will be up only slightly, access to plans will be improved, enrollment is expected to rise 11%, and benefits and cost sharing will be basically stable, according to the agency.
The gains, suggested Jonathan Blum, director of CMS’s Center for Medicare, in the news conference about the data, relate partly to the fact that “we are operating the program differently than it was operating in the past.” Among the differences, he added, is that “we are negotiating [with MA plans] much more aggressively.” He attributed part of the success to the health reform law, and both Blum and other CMS officials produced figures on the decline in MA premiums since the statute was enacted in 2010. It was exactly the message a presidential administration would like to get out a month and a half before the elections that would decide its future.
How bright that future is for MA, though, is in doubt. For one thing, medical services utilization seems once again on the rise, albeit still relatively low. For another, the bulk of MA plan payment cuts under the reform law hasn’t yet taken effect, nor has the “fee” on insurers that begins in 2014. And perhaps most importantly, the huge CMS stars bonus demonstration for quality, which brings sizable rewards even for three-star plans, ends in 2014, although a more modest program with rewards for only high-rated plans continues after that.
Do you think the outlook for the MA program will change after this year’s elections? If so, how? Will CMS’s support be as strong in the possible second Obama administration as it is currently? CMS and the MA industry seem to share many of the same short-term goals now, but will they still be “bedfellows” over the longer term?
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