Study: Managed Care Helps Sick Beneficiaries

By Staff Writer

May 19, 2006 at 10:57 AM

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Researchers who are concerned about the effects of the Medicare managed care program on consumers say even sick members of the managed care plans usually save money.

A team lead by Brian Biles of George Washington looked at 88 Medicare Advantage managed care plans for the Commonwealth Fund, New York.

The researchers compared hypothetical members' expenses in the managed care plans with the expenses the members might incur if they had traditional Medicare coverage along with Medicare Plan F supplemental coverage.

The hypothetical members in good health could lower out-of-pocket costs by joining any of the 88 Medicare managed care plans, and the hypothetical members in fair health could save money by joining all but 2 of the managed care plans.

The researchers found that 19 of the managed care plans were less generous for sick members than Plan F would be. The researchers estimated that sick members could end up paying as much as $2,195 more per year out pocket if they joined the managed care plan with the least protection than if they signed up for Plan F coverage.

The researchers are recommending that officials find a way to offer more protection for Medicare beneficiaries in poor health.

But the researchers also reported that 69 of the 88 Medicare managed care plans studied appeared to be a better deal than Plan F even for sick beneficiaries.

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