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AHIP: Medicare Test PPOs Were Helpful

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NU Online News Service, Sept. 29, 2004, 5:35 p.m. EDT

America’s Health Insurance Plans, Washington, has criticized a new government report that attacks the performance of Medicare preferred provider organization test plans.[@@]

The U.S. General Accountability Office argued that the test plans exposed beneficiaries to high out-of-pocket costs and increased the government’s expenses.

AHIP President Karen Ignagni has issued a statement pointing out that the Centers for Medicare and Medicaid Services, the agency that runs Medicare, already has changed its Medicare Advantage managed care program rules.

She also argues that the CMS has gained valuable experience from the PPO test plan program that will pay off later.

CMS PPO program statistics show that “beneficiaries who choose [Medicare Advantage] could save over $700 in out-of-pocket costs when compared to those in [fee-for-service] Medicare, and we know that individuals with chronic diseases save even more,” Ignagni says in the statement. “Even the GAO agrees that PPO demonstration plans have reduced out-of-pocket costs for beneficiaries in poor health by providing extra coverage for inpatient hospitalization services and prescription drugs.”