Issue link: https://viewer.e-digitaledition.com/i/1439655
RECENTLY WE HAVE seen select physicia n g roups a nd hospita ls say ing no to cer ta in Medica re p l a n s . R e i m b u r s e m e n t a n d a c c e s s b a r r ier s for p a t ient s a re of t en cit ed a s t he t ippi n g p oi nt s for pr o v i der s e x it i n g the networks. For consumers, the complexity of choosing between a traditional Medica re pla n a nd a Medica re Adva ntage Pla n — combined with the rejection of cer ta in pla ns by providers — fur ther adds to the frustration felt by ma ny patients. Each yea r, in late fa ll, consumers a re a llowed to switch hea lthca re pla ns a nd a re f looded with print a nd electronic ma rketing from insurers offering a va riet y of enticements a nd covera ge options. New en rol lees to Medica re must consider a nd sign up immediately or incur future pena lties. Consumers switching between Orig ina l Medica re a nd a n Adva ntage Pla n must ca refully consider what options they ga in or lose. Additiona l ly, people who travel a nd live in different places face a nother set of complexities. There is no point at which patients a nd prov iders a re connected in this conversation other than knowing whether the insurer being considered is in the net work. Yet when choosing a policy, understa nding how a physicia n functions within the plan or providers are paid is at the core of Medicare. PEERING UP AHEAD Health2047, a Silicon Valley subsidiary of the AMA, aims to transform health care at the system level and sees continued reimbursement for telehealth as key to moving toward a value- based payment arrangement, which has been an important lesson learned over the past two years. The AMA ponders: + How much are payers willing to reimburse on a fee-for-ser- vice basis? + How much will the industry adopt value-based payment? Costco recently launched a service for its members to help them better understand their Medicare choices — which is what brought me to this subject. For all its complexity, Medicare is a unique program that offers a great deal of choice, and as the population ages, will continue to be a primary payer for providers, who should understand the importance of the educated consumer. Perhaps the best contribution we all can make as employers and providers is helping to promote the services and programs that support consumers in making informed Medicare choices. n Kathryn Ruscitto, Advisor, can be reached at linkedin.com/in/ kathrynruscitto or at krusct@gmail.com. Resources for Consumers 1. National Council on Aging | ncoa.org 2. A ARP | A ARP.com 3. Medicare Compare Analyzer | medicare.gov BY K ATHRYN RUSCITTO, ADVISOR MeDICare: Choice or Complexity M D N E W S . C O M /// M D N E W S C E N T R A l N E W Y O R K n 2 0 2 2 0 5