Talk:Medicare Advantage

message: Is anyone looking into it? I believe one step towards reducing the amount of external link would be to only link to main sites and not to individual pages across said sites. For example, there are several links to pages on medicare.gov, but the link to the main page would be sufficient. Puceron (talk) 06:19, 14 November 2008 (UTC)
replies: text: I agree that there are too many links to government websites, but the others are a valuable resource to Medicare Advantage participants and potential participants, such as those just reaching 65. --DThomsen8 (talk) 14:49, 22 September 2009 (UTC)
thread_title:  Excessive External Links 

message: This article should talk about how Medicare Advantage is less efficient than Medicare because of administration overhead.
(above comment unsigned)
I agree entirely. This article is all rosewater. Recent debates in the health care reform process have shown how the 1997 Medicare Advantage deal in Congress simply followed the disastrous "privatization/deregulation" zeitgeist of recent decades (the same thinking that brought us the current Great Recession). The insurance lobby got Congress to cut private insurers a fat slice of our perfectly-serviceable Medicare system, letting them run up the administration overhead referred to above while simultaneously slashing the number of doctors willing to accept MA patients. This Wiki piece ought to be able to provide balance without bias. Presently, as another user has remarked, it reads like a PR release from Kaiser. At least check 
TravChar (talk) 18:40, 5 December 2009 (UTC)
thread_title: Criticism Section

message: This section refers to "Trustees" but nowhere in the article is it made clear who/what a Trustee is.
142.254.54.221 (talk) 10:49, 15 February 2017 (UTC)
thread_title:  Effects of the health care reform 

message: According to the actual source behind footnote #4, the "8 million members" only refer to Humana members of both Medicare Advantage and Medicare Part D plans, not Medicare Advantage plan enrollees nationwide.
The parts in question:
Speaking to shareholders gathered at Humana's downtown Louisville headquarters, Broussard emphasized that Humana Inc. (NYSE: HUM) would focus on "quality membership growth" in Humana's Medicare Advantage and Medicare Part D plans.  Medicare Advantage is [...].  Medicare Part D is [...].  Humana provides these privately administered Medicare plans to over 8 million members, according to a recent filing with the U.S. Securities and Exchange Commission.
Someone will probably have to review at least the other figure citations in this sentence to make sure similar errors don't exist (a quick glance at the 2015 numbers and they already seem wrong, the cited article was written in May 2014).  On an unrelated note, the sentence itself doesn't really fit in with the rest of the paragraph or the paragraph immediately preceding it, both of which focus on the Medicare Advantage enrollment process and not the numbers themselves.  --Dypsonian (talk) 07:22, 7 July 2017 (UTC)
thread_title:  2017 Medicare Advantage Enrollment Numbers Incorrect 

message: Hello fellow Wikipedians,
I have just modified 2 external links on Medicare Advantage. Please take a moment to review my edit. If you have any questions, or need the bot to ignore the links, or the page altogether, please visit this simple FaQ for additional information. I made the following changes:
*Added archive https://web.archive.org/web/20080116042258/http://www.kff.org/medicare/choice.cfm to http://www.kff.org/medicare/choice.cfm
*Added archive https://archive.is/20130918113944/https://opencrs.com/document/M20130326/ to https://opencrs.com/document/M20130326/
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thread_title:  External links modified (January 2018) 

message: , I'm inclined to revert a couple of these large September 30 edits since they move so much around that it's hard to evaluate. Also, in this edit I noticed that you deleted various stuff without explaining why, including the sections on utilization management, appeals (which I added), stars in rating systems, and competition. These are all important areas that need to be discussed, not just removed. Please ping me when you respond. Ideally you should re-add a bunch of the stuff you deleted. If you do not respond, I may go ahead and revert your changes per WP:BRD. Also, I was thinking about adding more about how payments are calculated using How Medicare Advantage Plans Are Paid: The Devils–and the Insights–Are in the Details but since this article is in flux I will hold off. II | (t - c) 04:40, 14 October 2019 (UTC)
thread_title:  Large Sept 30 edits hard to review 

message: I deleted the Program Structure section because it contained no references and lacked neutrality:  1 It was 1800+ words with no references or sources cited. 2. It presented a completely inaccurate information about the role of private organizations in administer Medicare and Medicare Advantage. It served as an opinion piece promoting the of the Medicare Advantage program rather than a neutral informative explanation of it.
I deleted all of the Usage section below the description of current enrollment figures that were supported with cited sources. Deleted all non-referenced comments about usage for lack of citation and lack of neutrality. That section was speculative and opinion-based, addressing potential future enrollment in Medicare and Medicare Advantage programs rather than presenting neutral information about known or past usage statistics. 
I deleted the entire History section because it was no supported by references other than two minor, narrow citations. One citation was an outdated, incomplete reference that addressed a disputed matter about financing statistics rather than the History of the program. 
Genwicky (talk) 02:43, 13 November 2021 (UTC)
thread_title:  Deleted large portion of entry--no references 

message: I had Medicare complete and now I have Medicare advantage will somebody please tell me what is going on 2601:581:4602:2DF0:B50B:9EC:C948:A93A (talk) 19:28, 23 June 2022 (UTC)
thread_title:  I had Medicare complete and now I have Medicare advantage will somebody please tell me what is going on 

message: This article in the NYT focuses on overbilling, but gives a good background on Medicare Advantage. Note that CMS had no way to systematically look for fraud; these were Justice Department suits in response to whistleblower complaints for which the whistleblower gets a reward. 
https://www.nytimes.com/2022/10/08/upshot/medicare-advantage-fraud-allegations.html
‘The Cash Monster Was Insatiable’: How Insurers Exploited Medicare for Billions; By next year, half of Medicare beneficiaries will have a private Medicare Advantage plan. Most large insurers in the program have been accused in court of fraud.
By Reed Abelson and Margot Sanger-Katz
New York Times
Oct. 8, 2022
The government pays Medicare Advantage insurers a set amount for each person who enrolls, with higher rates for sicker patients. And the insurers, among the largest and most prosperous American companies, have developed elaborate systems to make their patients appear as sick as possible, often without providing additional treatment, according to the lawsuits....
The popularity of Medicare Advantage plans has helped them avoid legislative reforms. The plans have become popular in urban areas, and have been increasingly embraced by Democrats as well as Republicans...
“You have a powerful insurance lobby, and their lobbyists have built strong support for this in Congress,” said Representative Lloyd Doggett, a Texas Democrat who chairs the House Ways and Means Health subcommittee.
Some critics say the lack of oversight has encouraged the industry to compete over who can most effectively game the system rather than who can provide the best care.
“Even when they’re playing the game legally, we are lining the pockets of very wealthy corporations that are not improving patient care,” said Dr. Donald Berwick, a C.M.S. administrator under the Obama administration, who recently published a series of blog posts on the industry. 
Nbauman (talk) 15:46, 8 October 2022 (UTC)
thread_title:  New York Times story 

message: Here's an article in STAT, one of the more independent and critical news sources on the health industry. It's behind a paywall, but it is a WP:RS which makes the argument that Medicare Advantage (1) is a drain on Medicare's trust fund and (2) is not saving taxpayers money, as it was supposed to do. 
Health insurers are painting a misleading picture of Medicare Advantage savings, experts say
Bob Herman
By Bob Herman 
STAT
Sept. 26, 2022
The health insurance industry is continuing its campaign to convince the public that Medicare Advantage saves taxpayers money, but experts say federal data still concludes the exact opposite — and that the program as currently designed is a drain on Medicare’s trust fund.
America’s Health Insurance Plans, the industry’s primary lobbying group, funded a new report that was conducted by actuaries at Wakely Consulting Group. AHIP claims the report proves Medicare Advantage — the controversial, private alternative to original Medicare that has become a cash cow for insurers — is “saving Americans billions of dollars every year.” The actuaries, however, never use that language in the report. Nbauman (talk) 15:58, 8 October 2022 (UTC)
thread_title:  STAT article