Medicare handbooks short on helpful info
Tuesday, Dec. 5, 2007
(Washington, D.C.) — Seniors trying to pick a private Medicare health plan this winter will have little help figuring out which plans are best, as the insurance companies once again fail to provide consumers meaningful data on the comparative quality of Medicare Advantage plans.
“The whole theory of the open enrollment season is that people can shop for the best plan,” said Bill Vaughan, Consumers Union senior policy analyst. “But the lack of quality data means people have no idea if they are buying health coverage that’s a pig in a poke.”
Consumers Union reviewed each of the “Medicare and You Handbooks” mailed by CMS to consumers at the start of the open enrollment period for the 55 geographical areas. The handbook lists the various Medicare HMO, PPO, private-fee-for-service, and special needs plans run by a dozens of private insurers in each state.
CU found only one piece of information on plan quality – the percentage of members who ‘rated their plan as the best.’ Of the 1,218 plans included in the handbooks, only 34 percent of the plans provided this quality rating information to the Medicare agency. Last year, only 19 percent of plans reported this one quality rating.
In fact, seniors shopping for plans in Alaska, New Hampshire, North Dakota and Vermont using only the handbook are provided with absolutely no data on plan quality, Consumers Union has found.
The CMS website does include more quality information than the handbook, such as right to appeal, drug pricing information and management of long-term conditions, but the availability of that data is also spotty. Also, it is estimated only about 60 to 70 percent of seniors have used the Internet.
“Because of the insurers’ failure to report data, the Medicare handbook on which many seniors rely has nothing meaningful about such things as customer service and price stability,” said Vaughan. “What’s even more troubling is that the one subjective quality indicator they do have is provided for only a third of all the available plans.”
Four of the 55 regions had absolutely no quality information in their handbooks; 20 regions had the quality indicator for one-quarter or less of plans. The handbook states that if information is not available, Medicare didn’t get the information from insurance companies in time to print it.
“Many insurance companies are clearly not taking seriously the issue of reporting their plans’ performance to Medicare,” Vaughan said. “If a plan fails to provide accurate and timely data, then it simply should not be included in the handbook. We are asking Congress to help CMS by legislating that no plan can be included in this taxpayer funded booklet, unless it provides basic quality data.”
Consumers Union has urged CMS to revise its quality indicator system for both its Medicare health and prescription drug plans offered by private insurers. CU would like to see simple data on key consumer quality issues that would allow Medicare beneficiaries to quickly identify the top handful of plans in their area.
Bill Vaughan, Susan Herold, 202-462-6262