|
Of the approximately 30.2
million seniors currently enrolled in Medicare Advantage, more than 5.2
million receive their coverage through an employer-sponsored group MA plan,
according to the latest CMS enrollment data. These offerings are growing as
the share of employers sponsoring retiree medical benefits is on the decline,
according to recent analysis from the Kaiser Family Foundation, which raised
questions about the lack of transparency around these plans and the potential
cost implications to the overall Medicare program.
Employers are attracted to
MA’s lower costs
- According to
the analysis of KFF’s 2022
Employer Health Benefits Survey, 21% of large employers (those with 200
or more workers) offer retiree health benefits for at least some current
workers or retirees this year, down from 27% in 2021. Meanwhile, 51% of
large firms offering such benefits do so through a contract with an MA
plan, compared with 45% in 2021 and nearly double the 26% observed in 2017, reported KFF.
- Of those large
employers offering MA to at least some portion of retired workers, 44%
do not give retirees a choice of coverage options, observed KFF. And
employers with 1,000 or more workers cited lower cost as the main reason
for moving to an MA plan.
- Meanwhile, a separate
survey conducted by global advisory firm WTW highlighted
employers’ growing concerns about the cost of providing health coverage
to retirees, and it indicated that many are thinking about replacing
traditional group coverage with individual insurance through private
marketplaces for that segment.
- “We’ve seen a
lot of change in the retiree medical marketplace due to economic pressures,”
Trevis Parson, chief actuary with Via Benefits, WTW’s individual
marketplace, tells AIS Health. This ranges from employer interest in
sponsoring group MA plans to funding early retirees’ ability to purchase
individual insurance through the Affordable Care Act exchanges. One of
the reasons individual MA is becoming such an attractive option for
retiree medical benefits is because of its rich prescription drug
benefit, which will continue to attract enrollees as the Inflation
Reduction Act (IRA) caps enrollees’ out-of-pocket spending in Part D
starting next year, he suggests.
KFF raises concerns about
impact to Medicare, retirees
- In its recent
analysis, KFF suggested the rising share of Medicare beneficiaries in
group plans “raises questions about the implications for retirees,
employers and the Medicare programs” and underscores the lack of
transparency about these plans, which have been under public scrutiny as Delaware and New York
City make futile efforts to implement them.
- Meanwhile,
little is known about the premiums, cost sharing, supplemental benefits
and provider networks in these plans, observed KFF. This makes it
difficult to “assess the extent to which Medicare overpayments may be
offsetting employers’ liability for retiree health coverage,” suggested
the KFF research.
- KFF cited the
Medicare Payment Advisory Commission, which in its March 2022 Report to
the Congress estimated that government payments to employer plans will
average 102% of fee-for-service spending in 2022. This “contributes to
higher Medicare spending that ultimately affects the solvency of the
Medicare Trust Fund and higher Medicare premiums paid by all
beneficiaries,” added KFF.
|
No comments:
Post a Comment