Because of the effects of the new health bills, Americans probably will get more health care in coming years and pay less for the services they use.
Analysts in the Chicago office of Fitch Ratings Ltd. have published that prediction in a commentary on the possible effects of the new Patient Protection and Affordable Care Act and H.R. 4872, the Reconciliation Act of 2010, a PPACA “fixer bill” which appears to be well on its way to becoming law.
PPACA and H.R. 4872 could squeeze the Medicare Advantage private Medicare plan program, Fitch analysts write.
PPACA and H.r. 4872 would freeze program payments in 2011, and they would start cutting reimbursement levels to 95% to 115% of traditional Medicare levels in 2012, the analysts write.
“Consequently, reimbursements will be lower in denser urban areas with larger Medicare populations and higher in more rural counties with few seniors and providers,” analysts write.
The highest-quality plans will get a 5% incentive payment, but a 85% medical loss ratio minimum would be enacted starting in 2014, analysts write.
Even before PPACA was signed into law, changes that require Medicare Advantage private fee-for-service plans to use provider networks caused some companies to scale down or shut down Medicare Advantage programs, the analysts write.