• Heritage Action
  • More

Private Health Plans in Medicare: What is the Record?

Recorded on April 28, 2009

Location: The Heritage Foundation's Lehrman Auditorium

Congress will soon face some big decisions on how best to improve Medicare's performance. In undertaking this task, they will have to address both the traditional Medicare program as well as the Medicare Advantage program, the new system of competing private health plans created by Congress under the Medicare Modernization Act of 2003. This discussion on the future of Medicare Advantage will take place within a broader debate on health care reform, where Congress will be discussing the reform of the private health insurance market to expand coverage, possibly with a competing public health plan to guarantee security of coverage for those who do not have access to employer-based coverage or other types of government program coverage.

What do we know about the performance of private health plans in Medicare? How do they stack up on performance measures? How do these compare with performance with traditional Medicare in the same local areas? What is the record of these plans on hospital stays, co-morbidities, ER visits, outpatient and office visits, readmissions, and most importantly, "potentially avoidable" admissions? Examination of some recent data on these subjects and what it means will be undertaken by two expert panelists: Jeff Lemieux will present his findings in this area and Robert Berenson, M.D., a former top official at Health Care Financing Administration (now the Centers for Medicare and Medicaid Services), will provide comments and perspective.