A Closer Look
Rapid growth in Medicare costs is a critical issue that continues to stretch our nation's financial resources, burden taxpayers and threaten our already fragile economy. According to projections, the problem will only get worse, with Medicare consuming an ever greater percentage of America's gross domestic product.
The current, Original Fee-for-Service Medicare program is not designed to achieve outcomes beyond paying beneficiaries' claims and guarding against fraud and abuse in the program. Lawmakers built the Medicare program on this limited model in 1965—and little has changed.
The problem: Federal Spending, as a Percentage of Gross Domestic Product
Source: Congressional Budget Office – “The Long-Term Budget Outlook”, June 2009.
Now more than ever, our nation must use its health care dollars wisely. Instead of simply curing illness, we must foster wellness and develop ongoing strategies to coordinate care, manage chronic disease and improve overall health.
The Medicare Advantage program unites these elements, making it an important choice for people with Medicare and a valuable tool that—over the long term—can help the Medicare system overcome its cost challenge.
Medicare Advantage: A Focus on Well Being
More than ten million Medicare beneficiaries, or more than one in five of those eligible for Medicare, rely on Medicare Advantage plans to keep them healthy, alert and active. Once enrolled, fewer than 2 percent of Humana Medicare Advantage members return to Original Medicare.
Why are these plans so popular? Medicare beneficiaries in Humana Medicare Advantage plans receive a coordinated approach to healthcare not generally offered by the traditional Medicare program. Going beyond coverage and claims processing, many of Humana's Medicare Advantage plans strive to help members improve their overall well-being with programs and services like:
- Support programs that help members work effectively with their physician to manage chronic diseases or conditions
- Care-coordination services for members with chronic or complex conditions or multiple diagnoses
- Telephonic nurse support designed to improve outcomes and offer peace of mind
- Senior-focused fitness programs designed to improve strength, flexibility, range of motion and cardiovascular condition
- Educational life-enrichment programs and classes, such as cooking, nutrition, fall prevention and smoking cessation
- Personalized statements detailing health care and prescription expenses
- Discounts on vision care, dental care, over-the-counter drugs and complementary and alternative medicine
The Medicare Advantage program is also a vital safety net for many rural and low- or moderate-income beneficiaries—especially those who earn slightly too much to qualify for Medicaid. For them, Medicare Advantage plans often provide a more affordable alternative to Medicare Supplement or Medigap policies. The extra attention to wellness, prevention, care coordination and disease management is also important to low-income and minority beneficiaries, who may suffer disproportionately from certain conditions, such as diabetes.