Some of your esteemed readers may be to the left of me on the political-economic spectrum and think the Commonwealth Fund is a bastion of The Man.
A lot of you are to the right of me, and way to the right of the Commonwealth Fund, and you might think the people there are a bunch of Commies.
But, wherever you are on the spectrum, I think you can all agree: Brian Biles, Giselle Casillas, Grace Arnold and Stuart Guterman have made a heroic effort to explain how Medicare Advantage funding and pricing works and explain how the federal laws now in effect would change that system.
Medicare Advantage is a program that gives private insurers a chance to sell coverage that replaces the traditional Medicare Part A hospitalization and Medicare Part B physician services coverage.
Biles, a health policy specialist at George Washington University, and his colleagues contend that Medicare program payments for Medicare Advantage enrollees were 14.2 percent higher than for traditional Medicare enrollees in 2009.
Policy changes included in the Medicare Improvements for Patients and Providers Act of 2008 cut the gap to 8.9 percent in 2010.
The analysts are predicting that, if all Medicare policies that are supposed to take effect between now and 2017 actually take effect, and work as expected, they will reduce the gap to 2 percent.
A quality bonus program could actually increase the level of payments going to the highest-performing Medicare Advantage plans, the analysts say.
That sounds great.
One thing I notice, though, as the daughter of parents who qualify for Medicare, is that the study doesn’t say anything about what the enrollees will pay, either in the form of premiums or out of pocket.
The folks at eHealth Inc. (Nasdaq:EHTH) have published a separate, much easier to understand analysis that shows what the average premium for a Medicare Advantage will be in 2013, what the average out-of-pocket maximum will be, and what the average premium will be at plans that charge a premium.
EHealth says, for example, that 47 percent of the Medicare Advantage plans in Alabama will charge no premium to enrollees at all, and that the average out-of-pocket maximum will be $4,187.