Back in 1979, a Florida court issued a gag order barring the Centers for Medicare & Medicaid Services (CMS) from revealing how much Medicare Part B was paying individual doctors.
The Wall Street Journal succeeded at getting the injunction overturned in 2011. You can now find the information on a CMS website. Many are heralding the data release as a leap forward.
See also: CMS may post more physician pay data
The data release has many shortcomings. It provides no information on treatments by doctors who are non-Medicare assignment doctors, patients who pay cash, or patients who have Medicaid. (Medicaid, of course, was greatly expanded by the Patient Protection and Affordable Care Act.)
The release also excludes patients in Medicare Advantage plans; patients who paid for their care with private insurance; and Medicare payments for inpatient hospital care, skilled rehabilitation services, durable medical equipment and prescription drugs. Finally, the data release excludes physicians who received Medicare Part B payments for fewer than 11 patients.
But, for advisors, there’s another problem: The information CMS has provided is not necessarily the kind of information that the average consumer who uses traditional Medicare coverage and Medicare supplement plans is looking for.
Transparency always seems like a good thing. There is certainly a need to know how the government spends taxpayer money. But consumers, typically, are looking for an easy way to get answers to questions such as whether a plan covers their doctors, hospitals or medications.
Medicare.gov has tips for keeping costs down with assignment, including what happens if a doctor, provider, or supplier doesn’t accept assignment.
You should make it a point to have more, and better, information about what’s going on with actual and potential Medicare providers in your community. Which providers take a client’s coverage is, clearly, also an issue in the Medicare Advantage market.
It’s obvious that senior clients will continue to need and seek out information about Medicare, Medicare supplement insurance and Medicare Advantage plans from trusted advisors. There are predictable buying behaviors an individual goes through as the individual ages into this phase of life. Clients will sign up for Social Security. They will automatically be enrolled in Medicare. A majority will purchase some form of supplemental coverage.
To get answers to their ongoing questions, they will seek the input from those they trust and count on.
Many advisors have added responding to this dominant buying motive to their practice because they realize there are two major concerns senior clients face in retirement: Their health will get worse, not better, and they don’t want to outlive their income or assets.
If health care is not part of a detailed analysis of a retirement planning client’s needs, or a senior client’s needs, the analysis will not be complete. That leaves the door open for the client and for the next sales person who comes through the door.