UPDATE: Medicare Advantage Growth Estimate At 0.5% For FY10
February 20 2009 - 6:26PM
Dow Jones News
Private Medicare plans would see a modest 0.5% increase in the
2010 fiscal year under tentative projections, a growth rate that
would come in well below some analysts' expectations.
Centers for Medicare and Medicaid Services, or CMS, said late
Friday that the current estimate for the growth of Medicare
Advantage, which affects payment rates to private insurers, would
be 0.5% for both elderly and disabled enrollees. Investment
analysts at Oppenheimer & Co Inc. had forecast rates would
increase by 2% to 4%.
Medicare Advantage plans are private insurers' version of the
popular U.S. government health program and Medicare
prescription-drug plans. The rate unveiled Friday was released as
part of an "advance notice," and a final rate for fiscal 2010 won't
be announced until April 6.
Private insurers taking part in the Medicare Advantage program
include Humana Inc. (HUM), UnitedHealth Group Inc. (UNH) and Aetna
Inc. (AET), as well as Blue Cross and Blue Shield companies.
Calculation of the 2010 growth rate for Medicare Advantage takes
into account a 1.1% decline in per capita costs for Medicare
Advantage enrollees. That decrease could be misleading, however,
because CMS has said that it is predicated upon Congress and the
president allowing a 20% drop in Medicare reimbursements to take
effect in 2010.
Lawmakers generally move to enact a fix to the reimbursement
rate - known as the "sustainable growth rate" - so that doctors
will continue to take Medicare patients. A CMS official in a
conference call Friday said that per capita costs for Medicare
Advantage patients could increase to roughly 3% if a physician
reimbursement fix is enacted.
-By Patrick Yoest, Dow Jones Newswires; 202-862-3554;
patrick.yoest@dowjones.com