Consumers Overwhelmingly Value Medicare Advantage Program

Blue Cross and Blue Shield Association Releases New Satisfaction Survey and Report Showing Medicare Advantage Provides Valuable Benefits and Coordinated Care

February 27, 2007

WASHINGTON – Virtually all (97 percent) Medicare Advantage (MA) beneficiaries believe it is important for Congress to work to maintain adequate funding for the MA program, according to a new survey examining satisfaction of beneficiaries enrolled in MA released today by the Blue Cross and Blue Shield Association (BCBSA). In addition, BCBSA issued a new report, "Medicare Advantage: Improving Care Through Prevention, Coordination and Management," highlighting innovative ways that Blue Cross and Blue Shield companies' MA plans are improving care for Medicare beneficiaries.

"These new reports clearly demonstrate extremely high satisfaction with the Medicare Advantage program and the enhanced value MA plans are bringing to beneficiaries through comprehensive benefits and innovative coordinated care programs," said Scott P. Serota, BCBSA president and CEO. "Unfortunately, Congress is considering additional cuts to the MA program beyond the $13 billion in reductions already enacted. These cuts would have devastating effects for MA members who are very satisfied with their MA plans and overwhelmingly want Congress to work to maintain adequate funding."

Satisfaction Survey Results

The new survey shows high overall satisfaction with the MA program, which provides coverage to more than 8.3 million Medicare beneficiaries. More than 8 out of 10 survey respondents (84 percent) said they are happy with their healthcare coverage and 75 percent would recommend MA to their friends or family members.

The survey also shows that beneficiaries believe sustained funding for the MA program is crucial, and nearly all survey respondents said it is important for Congress to work to maintain adequate funding for the program. Many worry that Medicare cuts could mean they could not afford to pay the bill for an unexpected illness (48 percent) or afford prescription drugs (45 percent).

Other key findings from the survey:

• Three-quarters of MA beneficiaries said their health plan is better than traditional Medicare;
• Low monthly premiums, quality of care and prescription drug coverage ranked as the most important benefits when choosing a health plan; and
• While many beneficiaries ranked healthcare coverage in this country as fair or poor (65 percent), most ranked their own health plan coverage in MA as good or excellent (67 percent).

The MA satisfaction survey was conducted by The Mellman Group on Feb. 5-11, 2007, among 1,004 Medicare beneficiaries. There is a +/- 3.1 percent of margin of error.

BCBSA Chronic Care Management Report

"Medicare Advantage: Improving Care Through Prevention, Coordination and Management," includes 11 examples of Blue Cross and Blue Shield chronic care initiatives that are improving care for Medicare beneficiaries. Eighty-two percent of Medicare beneficiaries have at least one chronic condition and 65 percent have multiple chronic conditions. According to a September 2006 report by the Institute of Medicine, traditional Medicare "does little to encourage coordinated, preventive, and primary care that could save money and produce better health outcomes."

In contrast, MA plans provide traditional Medicare benefits plus supplemental coverage in a comprehensive plan whose reimbursement structure encourages a focus on prevention and care coordination, reduces financial barriers to care, and creates an environment that fosters quality of care and satisfaction among members.

One case study included in the report is the Connections Health Management Program created by Independence Blue Cross (IBC). The program resulted in a decrease in inpatient days, and most importantly, high customer satisfaction ratings by providing specialized care to beneficiaries with the five most common chronic illnesses – asthma, diabetes, chronic obstructive pulmonary disease, chronic heart failure and coronary heart disease.

"The coordination of benefits available under MA has been integral to improving the quality of care for beneficiaries," said Dan Lyons, M.D., senior vice president, government programs at IBC. "Our Connections kidney program resulted in 12 percent fewer emergency room visits than expected and 19 percent fewer days at a skilled nursing facility than expected in its first year."

Highmark Blue Cross Blue Shield has several case studies profiled in the report. Judith Black, M.D., medical director of senior products for Highmark Blue Cross and Blue Shield, noted that the Diabetes Disease Management Program demonstrated measurable improvements in HEDIS® diabetes care measures, with scores that exceeded national averages in all measured areas. "Medicare Advantage is valuable because of the continuum of care that seniors and others receive through the program," she said. "MA gives beneficiaries access to education and healthcare programs that they may not receive under traditional fee-for-service programs."

The report also includes a diabetes management program from WellPoint, Inc. demonstrating how case management, member interventions and a provider pay-for-performance program, resulted in consistent improvement of HEDIS measures in diabetes care. "Chronic illnesses such as diabetes affect millions of Medicare beneficiaries and are best treated through coordinated care," said Sam Cramer, M.D., vice president of clinical programs for WellPoint, Inc. "Our diabetes management program is just one example of beneficial chronic care management programs accessible through MA plans."

Referring to the report, Serota said, "These innovative Medicare Advantage programs focus on providing high quality, coordinated care over the entire course of a disease, rather than focusing on individual episodes of care. If funding were cut, many MA beneficiaries who experience improved outcomes and quality of life and lower out-of-pocket costs may see their access to beneficial programs such as these stripped away."

For more information:

• Medicare Advantage: Improving Care Through Prevention, Coordination and Management
• Survey Executive Summary
• Medicare