Medicare Blog: Moorestown, Cranford NJ

Received award for "outstanding service and commitment to Medicare"

2/25/2020

During our general sessions at our NAHU Capital Conference in Washington DC, one of our speakers was Jim Parker, Senior Advisor to the Secretary for Health Reform, U.S. Department of Health & Human Services.

Jim had a great presentation about some of key initiatives the administration is focusing on related to healthcare reform. Two key areas that caught my attention were efforts related to reducing Pharmaceutical Drug Pricing and finding ways to reduce the costs and improve the experience for patients with End-Stage Renal Disease (ESRD).

Jim also happened to be actively involved with the Medicare Plan Finder activities we were working on with CMS.

At the end of Jim's presentation, he surprised me with this award.

What an amazing honor from such a senior representative at Health and Human Services (HHS).

You can watch the video of the award in the LinkedIn post below.

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Moderated medicare Panel with Congresswoman Allyson Schwartz

2/24/2020

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On Monday Feb 24, 2020, I was given the opportunity to moderate a Medicare Panel with some esteemed Medicare experts:

Congresswoman Allyson Scwartz, CEO and President Better Medicare Alliance
John Rother, President and CEO National Coalition on Health Care
Debbie Witchey, EVP/COO Healthcare Leadership Council

We had a really interesting discussion touching on several topics:

Financial Solvency of Medicare - based on the 2019 Medicare Trustees Report, the Medicare Hospital Trust Fund is scheduled to run out of funds in 2026 (if no changes are made to Medicare). We had an engaging discussion with different viewpoints on the panel regarding how real of a concern this should be and what some of the potential solutions could be for the future solvency of Medicare.
Growing role of Supplemental Non-Medical benefits (Social Determinants) with Medicare Advantage Plans - one of the key themes with healthcare reform is to identify the root cause of healthcare issues and create solutions to address the root cause to prevent/delay the healthcare issues. With Medicare Advantage plans, there are a number of new benefits (e.g. Dental, Vision, Hearing, Adult Day Care, Transportation, and more) that have been introduced to address some of these Social Determinants with a goal of improving healthcare and reducing healthcare expenses. One of the key points brought up in our discussion was the limited data that is available regarding the impact of these benefits since they are so new. In the next 3-5 years, there should be more concrete data around which of these Supplemental benefits actually provide the most impact on improving the healthcare of Medicare beneficiaries.
Medicare Advantage Plans covering End Stage Renal Disease (ESRD) Patients starting in 2021 - ESRD is a horrible disease that affects the kidneys. In most cases, individuals with ESRD will require dialysis and/or a kidney transplant. The cost for dialysis is roughly $10,000/month. Today, ESRD is one of the only medical conditions that can prevent someone from enrolling in a Medicare Advantage Plan. With the 21st Century Cures Act, the barrier for ESRD beneficiaries to enroll in Medicare Advantage Plans was removed beginning in 2021. This change coming to Medicare Advantage Plans next year will likely have major impacts on Medicare Advantage Plans. There is some discussion that the Maximum out of Pocket could be raised from $6,700/year up to $7,500 or even $10,000 to offset some of the costs of the dialysis treatment on the Medicare Advantage Plan. There was also discussion that the $0/month Medicare Advantage Plans may have to increase the premiums to offset some of the costs of these ESRD patients. These discussions are in the early stages but there will need to be some finalized communications coming in the next few months from the government and carriers as they start to request approvals for their 2021 Medicare Advantage Plan designs.

It was a great honor to moderate this panel and I look forward to continued partnerships between NAHU (National Association of Health Underwriters), Better Medicare Alliance, National Coalition on Health Care, and Healthcare Leadership Council.

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Medicare Advisory Group Panel in Washington DC

2/24/2020

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At the National Association of Health Underwriters (NAHU) Capitol Conference, I was able to participate in a panel with some of our Medicare Advisory Group Members to discuss some of the key areas that our group has been working on.

The individuals on the panel are listed below:

Mike Smith, President, The Brokerage Inc., Medicare Advisory Group Chair - TX
Maggie Stedt, Stedt Insurance Services - CA
Justin Lubenow, Executive Vice President at Senior Advisors, LLC - NJ
John Greene, NAHU Vice President of Congressional Affairs - DC

Key Topics discussed on the Panel:

Legislative Updates related to Medicare (John Greene) - there are several key legislative issues that NAHU continues to work on in Washington. Some of the key items John highlighted were: Cobra as Credible Coverage, Observation Status, and Medicare with HSA Contributions.
New Medicare Certification Course (Mike Smith) - Mike gave a great overview of a new Medicare certification course that NAHU is launching this year for agents to certify for Medicare Advantage and Part D Drug Plans. We are all very excited about this new Compliance course which will focus on relevant and important guidelines for agents that will be offering Medicare Advantage and Part D Plans.
Employer Coverage and Medicare (Maggie Stedt) - More and more people are working past the age of 65. This results in a number of unique scenarios between Employer Group Health Insurance versus Medicare coverage. Maggie highlighted some of the key things to consider when agents are consulting with individuals and groups in these scenarios.
Medicare Plan Finder Updates (Justin Lubenow) - I presented our work with CMS on the Medicare Plan Finder. Click here to read more.

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Meeting with CMS at Baltimore, MD offices

2/19/2020

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In August 2019, the government released a completely redesigned Medicare Plan Finder tool. The previous tool had not been redesigned in over 10 years, so CMS was looking to improve the beneficiary experience.

With the initial release, there were a number of issues that we quickly identified.

On October 1, 2019, I was given an opportunity to jump on a call with the key contributors at CMS to discuss some of the concerns from our association, National Association of Health Underwriters (NAHU).

Actual notes from our working group session on Feb 19, 2020 in Baltimore, MD with CMS.

On the initial call, CMS agreed to have twice weekly calls throughout the Annual Enrollment Period to allow us to raise any key issues/requests with the Medicare Plan Finder and work through them with CMS. So, these calls continued through the Annual Enrollment Period (ending December 7, 2019).

A lot of key issues were addressed from these calls with CMS:

Total Cost Calculator and Sort
Drug Pricing Issues
Deductible Calculation Issues
Mail Order Pricing Issues
Navigation Issues
Pharmacy Network Issues
And More...

These calls proved to be a very successful Partnership with CMS as we were all striving to improve the Beneficiaries experience with the new Medicare Plan Finder.

At the end of the Annual Enrollment Period, we still had a number of open items that would improve the Beneficiary experience with the Medicare Plan Finder.

In January, we received an invite to a meeting with CMS (on Feb 19, 2020) in Maryland to discuss the open items and next steps with the Medicare Plan Finder.

Quick Recap of Meeting from Feb 19, 2020 with CMS
The 3-hour meeting included key stakeholders from a number of difference groups:

Associations (AARP, National Association of Health Underwriters, National Council on Aging, Medicare Rights Center, Justice in Aging, Center for Medicare Advocacy, and more)
Carriers (UHC, Humana, Anthem, CVS/Aetna, Centene, Highmark, Humana )
Government Agencies (CMS, HHS, Administration of Community Living)

The room was setup into about 10 different working groups/tables with representatives from different groups at each table.

CMS kicked off the meeting with some background on the key drivers for creating a brand new Medicare Plan Finder tool. Then, we were given direction for the working groups to discuss a few key themes and come up with a list of "Things that are working well" with the Medicare Plan Finder and "Opportunities that are still open" with the Medicare Plan Finder.

One of the really interesting things that came out of this meetings is the feedback across the working groups was very similar. These are stakeholders from all different organizations impacted by the Medicare Plan Finder and the key themes overlapped significantly. Some of the highlights are below.

"What's Working Well" with the Medicare Plan Finder

Total Cost Calculator & Sort - this is an extremely important function that was not included in the initial release on August 27, 2019 but was later added (around October 10, 2019). This function allows a Medicare beneficiary to identify the most cost-effective Part D Plan
Look & Feel - the new Medicare Plan Finder is much "cleaner" looking than the old Medicare Plan Finder. There is more white space and information is generally easier to find
Mobile Optimized - the Medicare Plan Finder is optimized and responsive which means it displays nicely on a smart phone or tablet
Site Performance/Responsiveness - the infrastructure for the Medicare Plan Finder appears to be quite robust considering the volume of users and the speed of the site. Clicking from screen to screen is nearly instantaneous; there is not a lot of waiting for page loads with the new Medicare Plan Finder.

Some key "Opportunities" that still exist with the Medicare Plan Finder

General Communication/Transparency - this meeting on Feb 19 was a good start to keeping the communication open with CMS. We need to continue these types of discussions including a feedback loop so we understand the Roadmap and Priorities for new Functionality/fixes going forward.
Ability to save an Anonymous Drug List. For beneficiaries that don't have their Medicare Number yet (perhaps just analyzing the potential costs of Medicare Plans), there is no way for them currently to Save their Drug List information so they don't have to re-enter it every time they are reviewing options.
Ability to Calculate Total Annual Cost for a full year projection. Currently the tool only provides the ability to project Total costs based on the 1st of the following month which is useful to provide an estimate for the rest of the year; however, the current tool does not allow a new Medicare Beneficiary to budget out a full year of projected Part D costs for someone enrolling in the middle of the year.
Need some sort of indicator (e.g. Red Flag) on Plan Results Page for Plans that do NOT cover all the drugs in the formulary. This is critical because we are still finding examples of Incorrect Pricing displaying for non-covered drugs.
Improved Reporting - there are some report printouts available in the current tool however there are a couple of key issues with the reports: a Beneficiary is not able to run a Comparison report of multiple plans that shows the drug level pricing information to compare plans. Also, the printouts of the reports have a poor layout and take up about 15-20 pages; these could be reduced to about 10 pages with the same information included.

I really look forward to continued engagement and partnership with CMS as we look to improve the experience for Medicare beneficiaries going forward.

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CMS releases updated Hospital Star Ratings

2/6/2020

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Two NJ Hospitals Get 5-Star Rating

CMS has recently released updated Hospital Star Ratings, and two NJ hospitals received 5-star ratings: Morristown Medical Center and Saint Clare's Hospital.

You can search for other hospitals ratings using this link: https://www.medicare.gov/hospitalcompare/search.html

If you are interested in the Rating Methodology, you can find more information here: https://www.medicare.gov/hospitalcompare/About/Hospital-overall-ratings.html

Seminars at Morristown Medical Center

I am excited that I had the opportunity to present multiple Medicare Workshops at the Morristown Medical Center over the last couple of years, and look forward to additional seminars later this year.

Also, we wanted to extend an invite to a FREE seminar on a very important topic - Finding your Social Security Sweet Spot. The speaker for this Seminar is one of my close colleagues who is a Social Security expert, Ash Ahluwalia. If you haven't made your Social Security elections yet, I am certain you will find this Seminar useful and engaging. Details and registration can be found below.

Finding Your Social Security Sweet Spot
with Ash Ahluwalia
Thursday, March 5, 2020 I 12:00 to 1:30pm
Executive Conference Room, Third Floor
475 South Street
Morristown, NJ 07960

Navigating social security in our ever-changing financial climate can be daunting. Our guest speaker Ash Ahluwalia will break it all down to help you maximize your benefits. As president of National Social Security Partners and the 2016 National Social Security Advisor of the Year, Ahluwalia has helped over one thousand clients make the most of their social security benefits. Ahluwalia is a Certified Financial Planner (CFP) and a Chartered Accountant (CA) with two designations in social security planning and an MBA from Wharton Business School. Lunch will be provided for all attendees.

Register Now

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Received award for "outstanding service and commitment to Medicare"

Moderated medicare Panel with Congresswoman Allyson Schwartz

Medicare Advisory Group Panel in Washington DC

Meeting with CMS at Baltimore, MD offices

CMS releases updated Hospital Star Ratings

Two NJ Hospitals Get 5-Star Rating

Seminars at Morristown Medical Center

Justin Lubenow

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