Moderated medicare Panel with Congresswoman Allyson Schwartz

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.