Insurance companies are given a set amount of money for each person they sign up for Medicare Advantage. Some rumors put the figure at $100,000... a year per person... Any money the 'Advantage' plan doesn't spend on the person, they get to keep. It's why they advertise everywhere... it's one big cash cow with perverse incentives ...
Why a cash cow?
Because boomers are still in their sixties and younger. Not a time when medical care is costly (compared to what it will be in 10 years.)... Advantage programs can dump promises every year and it's totally legal. IN the mean time sane insurance plans like the medi-gap 'F' plan (yes, it pays excess charges - which will keep a person from going broke when they have medical needs) will become unavailable to the elderly.
One perverse incentive in the Advantage plans is to deny expensive medical care - care like operations... and to instead offer a pill... remember, 'the plan' gets to keep ALL money not spent on a person in any given year... Same for the 'doctors' they hire... Any money NOT given to a doctor is money the Insurance company gets to keep. Doctors working for salary might not be the top-of-the-class guys... plus if a plan doctor asks for too many high cost items (MRI's specialists etc) for the patients they'll be replaced. Incentives work that way. It's what makes some 'perverse'.
Obama's reducing what he's paying insurance companies who deal in Advantage' to help the ObamaCare scam look better... The goal appears to be for the US Government to take a large cut of health care dollars. Take those dollars - skimming them from citizens, Insurance companies, doctors, health care providers etc. and keeping the money for themselves... and the dependent ones who keep them in office. These are liberal elites at their worst. There is no free lunch... And all the above is in my humble opinion... I'm open to any facts and corrections freepers have...
we have SCAN which is a non profit Advantage plan and they not only have top doctors but you can even have services not within the plan.
I had Cyberknife to cure my lung cancer and they paid 100% of it and all I have had to ever pay was a co pay for the PET scans.
They did increase the co pays for next year to cover what obama stole, but not that much.
yes the MA plans offer all sorts of incentives to the members and most if not all health plans offer some type of incentives to DR's for good outcomes some by quarter some at yr end.
I have never denied a payment to a dr or hospital for any surgery.