Direct conversation is what everyone wants, but it is rarely understood.
At the Medicarians conference held earlier this month in Las Vegas, I had the opportunity to involve Sachin Jain, CEO of Scan Health Plan, in a health talk by the fire to talk about the current state of Medicare. While exalting the benefits of Medicare Advantage, Hey did not shy away from difficult questions about the program and also agreed that the program needs changes.
SCAN is a health plan for Medicare Advantage Non -profit with annual income of $ 5.5 billion and a base of members or 301,000 older people. Watch the full video below:
I am the first to call my baby ugly (Timeestamp video 22:01)
Medicare Advantage was conceived as a way of controlling Medicare’s costs and offering the elderly more options. But the program, although it exploits in popularity, more than 54% of the population of eligible medicines is now registered in an MA plan, has not fulfilled its original mission to reduce the costs of the federal government.
The Medicare Payment Advisory Commission (MEDPAC), an independent agency of Congress, projected that in 2025, the Federal Government Woldern spends approximately $ 84 billion more for MA Thanhhan affiliates if those beneficiaries registered. This represents a 20% increase in spending for ma plans. Then, only for this fact, the Rai · Son d ‘· tre, or reason to be, because ma seems to be defective.
Separately, KFF (Kaiser Family Foundation) conducted an analysis in 2022 or 62 published studies on MA and Medicare since 2016 and concluded that they are very important differences between the two programs. Neither MA nor traditional Medicare served consistently better than the other in all quality measures.
When that question was asked, Jain initially released a defensive tactic and provided a financial reason to refute the data and the question.
“I worry about the affordability of people,” Jain replied. “Nothing there speaks real about the affordability of people’s pocket.”
When the plenary audience broke out in applause, he continued:
“At the end of the day, we have to think about the beneficiary and we have to think about what they can pay and what they can pay.”
Previously in the interview, Jain described the affair crisis in traditional Medicare. He described a married couple with an average income of approximately $ 54,000 that becomes eligible for Medicare and have to pay a premium of part B or $ 184 per person per month, and then pay for the part of the coverage of prescription medications and the supplementary benefit.
“Therefore, they have spent their entire life in the payment of Medicare taxes … and at the end of their life, they have the privilege of paying $ 12,000 or their income of $ 54,000 to pay their health success,” he said. “Therefore, it is a fundamental broken system that does not resemble anything that Harry Truman original imagined when Hey Child of imagined the Medicare program,” Jain explained.
It is in this context of lack of affordability that ma should be compared to Medicare, he said. But at the same time, Jain did not go through the real problems within MA: the cost and the “dire practices” that deceive the elderly. Those have led the calls to eliminate the medical term of Medicare Advantage.
“I think this program is demanding, and I think we need to solve aspects of him and there are bad actors who have escaped with the risks adjustment, and we need to solve it. The home evaluation game has GODOS out of control. We sacrifice so many many of many many of many scenes. A lot of lots of lots of lots of lots of lots of lots of lots of lots of lots of lots of lots of lots of lots of lots lots of lot lot lots of lot lots of lots of lots of lots of lots of lots of lots of lots of lots of lots of lots or practices in the industry, and many people do not necessarily know what they are buying.
Later he added that MA “can cost more, but it may also be due to the fact that he does more and that is something we are not talking about enough, what we should be doing more for older adults in this country.”
What Dr. Oz thinks of Medicare Advantage runners (Time brand: 26:59)
At the beginning of April, when the Medicarians conference was a hero, Mehmet Oz had not yet been confirmed by the Senate to direct the Medicare and Medicaid service centers. What many conference attendees did not know or was the fact that Oz was one of them: New York time reported in February that Oz is a license runner, capable of selling ma in more than 20 states.
And the issue of Ma was something that OZ himself raised towards the end of his Senate confirmation hearing. When Senator Ron Wyden (D-ORGON) asked Oz what he thinks are “the greatest abuses are currently in the private insurance sector” OZ replied “sales of Medicare Advantage.”
Oz then added that the rotation, insurance corridors who sell policies so that older people constantly change from one plan to another, was something that should be analyzed. He pointed out that if the elderly did not have to select a plan every year, then perhaps money could be saved from the middle that the runners are now Bolsan. He added that there are probably too many mastery agents, some good, some bathrooms.
When asked to respond to that, Jain replied that there are good brokers and bad runners in the same way that there are good journalists and bad journalists, good CEO and bad CEO. He cheered that some bad runners gave the entire industry a bad name and then decided to issue a call to action to the hundreds of audience runners.
“I have had this proposal for a while … It is the idea that we should re -build the runners, because I think the runners only implies that all you are doing is selling something, such as community health workers. I think we need a cultural change in this industry.”
Photo: Medicarian