Tag Archives: Medicare Advantage

Part Two explores where Medicare should be going forward as determined by doctors Richard Gilfillan and Donald M. Berwick. It is an endorsement of the ACO model with changes to it creating greater efficiency. I am not so sure Kip Sullivan would endorse this approach as opposed to Single Payer. Ultimately Single Payer is less costly when we consider the elimination of much of the administration effort. There is another post I will be putting up when I...

And the news Media is waking up to this? In December 2022, NPR wrote, “Medicare Advantage plans overcharged Medicare by millions,” Health News : NPR Citing an April 26, 2016 example of US government auditors asked a Blue Cross Medicare Advantage health plan in Minnesota to turn over medical records of patients treated by a podiatry practice whose owner had been indicted for fraud. Medicare had paid the Blue Cross plan more than $20,000 to...

Medicare Advantage Over Payments In the conclusive summation of the latest KFF report on Medicare Advantage Healthcare plans which KFF also has in place, is this: Historically, one goal of the Medicare Advantage program was to leverage the efficiencies of managed care to reduce Medicare spending. However, the program has never generated savings relative to traditional Medicare. In fact, the opposite is true. As a result, Medicare Advantage...

A good article on hospital increasing healthcare costs, due to consolidations, supplies, and the associated hospital operational management. The article also engages in a book review of Big Med by David Dranove and Lawton Robert Burns (“Megaproviders and the High Cost of Health Care in America“). I will have to check the book out and advise later. Towards the end of the article, Shannon has included elements of Single Payer in her review-critique...

Introduction: FFS Medicare Overhead costs are ~2%. Medicare Advantage overhead costs are far higher. The same can be said for commercial healthcare costs paid by insurance companies. Neither MA administered healthcare or commercial insurance plans can compete with FFS Medicare for costs and care. I will touch on a few reasons why on Medicare at the end of this article which came by way of Dale Coberly, the resident expert of today’s SS. As...

Introduction: Before I get started on the main text of Kip’s expert article, I wish to point out something which is happening nationally. There is a plan afoot of forcing people into Value-Based Payment plans from traditional Medicare. The players include Iora Health (subsidiary of One Medical), Privia, General Catalyst, agilon health, Caravan Health, Signify (CVS owned), Village MD (Walgreens owned), Premier, etc. This is being done in...

This was sent to me by Dale Coberly. I was wondering why Dale was sending me trash advertisements. Skimmed it and then it dawned on me. Much of this advertising is made to sway people’s minds to do something. It is the type of advertising I sometimes wish to throw a shoe at the 65-inch screen when it should be shown on a 12 -inch screen. It is especially aggravating, when the advertising includes the famous, the rich, the good-looking, etc....

This is an interesting result I ran across in MSN as taken from Reuters. Both Kip Sullivan and I have written about Medicare Advantage plans over coding patients, resulting in overcharges to CMS Medicare. “Why is CMS Overpaying United Healthcare Medicare Advantage Plans?” – Angry Bear, “Medicare Advantage and Medicare Issues” – Angry Bear, “Kip Sullivan and Ralph Nader Talk Tradition Medicare vs Medicare Advantage” – Angry Bear, etc. Advantage Plans...

Introduction I am fortunate to have made the acquaintance of Kip Sullivan from reading his articles and exchanging notes over the last couple of years. He is one of the more knowledgeable authorities on Single Payer as well as healthcare costs and price, commercial healthcare insurance, Traditional versus Advantage Medicare, and why today’s healthcare is not working efficiently. For example, commercial insurance administration costs are an...

This podcast came to me by way of Kip Sullivan, the expert on Traditional Medicare and Medicare Advantage. We have had a running dialogue for about a year now. Most recently, Angry Bear featured Kip’s PNHP Single Payer Healthcare Financing Series detailing why healthcare is expensive in the US. I have put up numerous posts on healthcare, Medicare, Medicare Advantage. This podcast by Kip and Ralph Nader gets into the take over of Traditional...