Can Administration Find Cure For Medicare+Choice Ills?
The Medicare+Choice program is in bad shape. Just look at its vitals: Forty-three HMOs in 30 states — including such heavy hitters as Foundation Health Plans, Oxford Health Plans and WellCare Management Group — as well as 22 “demonstration plans” have decided to pull out of the Medicare market before Medicare+Choice debuts next month, and another 53 have decided to cut back their services; more than 400,000 Medicare beneficiaries are expected to be dropped by Medicare HMOs; and about 1 percent of the 6 million folks enrolled in Medicare HMOs may be forced to join fee-for-service Medicare in 1999. Health plans say they’re leaving Medicare+Choice for several reasons: Costs are escalating, reimbursement rates are plummeting, regulatory requirements are too burdensome and the administration is inflexible about the rules. Administration officials argue that in 2000, risk adjustment will kick in with additional payments for health plans that say they’re struggling to make ends meet under Med
