In-Portal Developers Guide

This is a wiki-based Developers Guide for In-Portal Open Source CMS. The purpose of this guide is to provide advanced users, web developers and programmers with documentation on how to expand, customize and improve the functionality and the code the In-Portal software. Please consider contributing to our documentation writing effort.

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Medicare Advantage is known as the private alternative to the traditional Medicare program for seniors (Ubezpieczenia Olsztyn). It covers approximately 11.7 million Americans and is seen as more expensive by many. On the flip side, some experts believe Medicare Advantage plans are cheaper. This leaves many Americans very confused especially in todays health care environment. This could get even more confusing if there is an overhaul to the Medicare plan as we know it. The Balanced Budget Act of 1997 aimed to open up the public insurance program to private plans to offer more versatility. The independent Medicare Payment Advisory Commission concluded in their 2002 report that this movement was not increasing competition as it originally aimed to do. The availability of plan options have not increased as much as they had hoped. After this report, Congress passed another law, the Medicare Modernization Act, which aimed to boost the payments to private insurers received for covering those enrolled in Medicare. As of 2004, Medicare Advantage started paying private plans a higher per-enrollee cost when compared to the public plan. Sarah Kliffs article on the Washington Post includes a chart which shows this continued to be the case during the past eight years. While it is clear that the government pays more to provide the same set of health care benefits through Medicare Advantage, some experts claim Medicare Advantage is not more expensive overall. James Capretta and Yuval Levin argue that Medicare Advantage plans are cheaper citing a recent study from the Journal of the American Medical Association. The research compares what would happen if the Ryan-Wyden Medicare reforms were implemented during this market. Seniors would start getting a check from the government to purchase a public or private plan, but the amount of the check isnt clear. Medicare would go through many bids that private insurance companies submit showing how much they say it will cost for a Medicare beneficiary to be covered. They then would give each senior a check equal to the second-lowest bid. Back in 2009, the second-lowest bidder claimed they could cover Medicare benefits for much less than the public program. This is why some people say Medicare Advantage is actually cheaper. This of course begs the question of how Medicare plans can be less expensive for seniors, but more expensive for the government. It ultimately has to do with the cost of health benefits and how much is paid for them. Currently, what the federal government pays private plans is more than the actual cost of providing the benefits. Kliffs article says this is because the government has a benchmark for how much it ends up paying health plans for each senior that is enrolled. The benchmark is generally higher than the per-senior cost of Medicare. As the health insurer bids lower than the benchmark they get a rebate for the difference. This doesnt automatically mean that Medicare Advantage is overall cheaper. There are a lot of factors in play, such as the health of customers, that determine how high costs really are for Medicare Advantage. The debate continues, but one thing remains true. If Medicare is overhauled, Medicare Advantage will change as well and a new debate will be on the table making Americans even more confused than they already are when it comes to Medicare.