KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Medicare Advantage Plans Are Largely Unpopular In Rural States

Kansas Health Institute examines Medicare Advantage plans, which are less popular in rural areas, in a series of reports: "In Kansas, about one in 10 Medicare beneficiaries is enrolled in a Medicare Advantage plan. That's about half the national average. Medicare Advantage plans, which have about 40,000 Kansas participants, tend to be more popular in urban states where the beneficiary pools are larger and most doctors and hospitals participate in the plans. But in a rural state like Kansas, it's not unusual for a small town doctor to refuse participation in Advantage plans because they mean more paperwork and less pay. Most small town hospitals also balk at joining an Advantage plan network."

"'If you're a hospital, the reason you'd sign up for an Advantage plan is to get a certain number of patients you're not getting now. You agree to see them for less based on the likelihood that you'll be seeing more of them and come out ahead,' said Dennis George, chief executive for the Coffey Health System hospital in Burlington. 'But if you're the only hospital in a small town, it's pretty unlikely that you'll be seeing more patients and the last thing you want to do is see the same number of patients for less money.' ... Today, Advantage plans are subsidized by Medicare and cost, on average, between 12 percent and 14 percent more than traditional Medicare" (Ranney, 11/9).

In a separate article, KHI reports on support for cuts to Medicare Advantage plans: "A key provision in the health reform bill passed late Saturday by the U.S. House calls for cutting billions of dollars currently spent on federal subsidies to Medicare Advantage plans. Those savings would then be shifted to help underwrite the expansion of health insurance to millions of Americans. But the Medicare Advantage plans, if the bill becomes law, will have to find ways to cover beneficiaries for less than what standard Medicare services cost or, most likely, go out of business. That's all right with Kansas Insurance Commissioner Sandy Praeger, a Republican." (Ranney, 11/9).

In another article, KHI reports on seniors' differing views of Medicare Advantage plans. Pam Brown, a counselor at the Jayhawk Area Agency on Aging office in Topeka, says that dissatisfaction "comes when seniors realize they're paying higher co-pays and deductibles than if they'd opted for regular Medicare and supplemental coverage, or when they realize their doctor or hospital is not part of their Advantage plan's network. ... Those who 'love' their Advantage plans, she said, usually cite the lower premiums and the access they provide to free or low-cost services such as dental care, eye exams, hearing aids, or fitness club memberships" (Ranney, 11/9). KHI also includes an explanation of the Medicare Advantage program (11/9). This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.