Depends on who you ask. If you ask group practice administrators about how Medicare compares to the private insurance industry, it is pretty darn good – in several categories, Medicare Part B is rated higher than any other large payer.
That’s partly due to the lousy performance of some of the private insurers, but administrators actually rate Medicare’s responsiveness, transparency, prompt payment, and overall administrative functions highly.
Yes, you read that correctly.
On a five-point scale, with 5 the highest rating, the much-maligned and oft-decried public plan for the aged has an overall satisfaction rating of 3.6, with Aetna at 3.1 and UnitedHealthcare bringing up the rear at 2.5.
Medicare was considered the most timely responder to inquiries, with Aetna second and UHC at the back of the pack; the same standings hold for accuracy and consistency of the payer’s responses to questions, speed of payment (Medicare 4.1, Aetna 3.5, UHC 3.1), disclosure of payment policies, and claims appeal process (Aetna was excluded from the report).
Medicare doesn’t appear on the list of questions regarding satisfaction with the contracting process, except in the ‘willingness to disclose the fee schedule’ category, where it is again rated at the top. This isn’t surprising, as CMS is not engaged in ‘2-way good-faith negotiations’ nor do practices have ‘leverage during the negotiation process’. I don’t know if responders didn’t ask about Medicare or if Medicare was ranked at all; I’ll let you know when I hear back from the Medical Group Management Association (MGMA), the organization that conducted the study.
As with any study or survey, you can find data to support any perspective.
That said, the ratings of the health plans are generally consistent with those reported by the Verden Group, an independent firm focused on helping providers deal with managed care organizations.
Aetna received top marks for clarity of communications, and was rated the most ‘provider friendly network’ by respondents to the Verden Survey in 2008.
As the public option becomes possible once more, and opponents lament the inefficiency, lousy service, and incompetence of the faceless bureaucrats that run Medicare, it is helpful to know what the people on the other end of the transaction think.
If you listen to them, on a number of fronts, Medicare’s a darn sight better than most of the private insurers they have to deal with
Oct
27
Hardly surprising since fee-for-service Medicare doesn’t manage care at all, just pays claims rather efficiently. Or, rather, the private carrier that does the claims administration for Medicare pays the claims efficiently. Fee-for-service Medicare is not a “public plan”. It is a government-financing mechanism only. The American public has been conned into thinking that fee-for-service Medicare is just like the public option, when nothing could be further from the truth. The public option is a government-controlled health plan that will be created from scratch with enormous price advantages over the private carriers, but with no prior health plan expertise, or any experience in actually managing a defined membership of health plan enrollees. Pretty scary.
Having read through some of the various bills out there, it sure does not look like Medicare to me. The government will be far more involved in the decision making process with the “Public Option” and far more “helpful” in assisting you with healthcare decisions. The means by which they have gone about this whole process have not created a lot of confidence that they will implement an effective solution, way too political. Mickey Herbert mentioned in his comment, “pretty scary.” I agree.
Mickey: I have only read your version of what the public plan will be in some rogue e-mails. Which bill currently before the House or Senate details that the public option will be as you state?
United has always sounded like an administrative headache. I had it for a while, and I’m pretty sure that the only reason I was able to find a doctor to take me was that she practiced out of a non-profit hospital with good fundraising.
Currently I have a Medicare Advantage plan which I subscribed to through PlanPrescriber.com. Previously I had government Medicare. I think both have their shortfalls in certain areas. But from a patient’s perspective, I found better access to doctors and better customer service with my Medicare Advantage plan.
Really wonderful piece of information and I appreciate it that you share something so useful with the readers of this blog.