Some Northeast providers are stepping up their campaigns to promote traditional Medicare coverage over coverage through Medicare HMOs.
This month, the Connecticut Hospital Association mailed 390,000 brochures to state residents and kicked off a seven-month radio advertising campaign. Both the direct-mail pieces and radio spots call traditional Medicare "a secure alternative to Medicare HMOs."
Meanwhile, the North Shore Physician Organization, a 1,000-member network in Nassau County, N.Y., said it plans to launch a second series of campaign materials after HCFA Region 2 in New York OK'd the group's earlier campaign, which urged senior citizens not to give up traditional Medicare. HCFA regional administrator Judith Berek said in December 1998 that her staff would review the materials for any violation of Medicare rules (Dec. 21-28, 1998, p. 14).
Traditional Medicare costs beneficiaries more in out-of-pocket expenses but generally pays providers better than HMOs do. Both provider groups said they are trying to perform a public service, not protect their wallets.
The moves also come at a time when a number of provider groups in Washington are vehemently complaining to lawmakers about alleged payment shortfalls from Medicare. The push by the providers in Connecticut and New York suggests that at least the traditional Medicare program may not be such a bad payer.
Gerard Robilotti, chairman of the 31-member Connecticut Hospital Association, said hospitals have an interest in a better-informed constituency. The association's ads and brochures urge senior citizens to seek unbiased information, and include phone numbers for the state's agency on aging.
"I think there is some concern that all of the options available, including traditional Medicare, (are) not being effectively communicated," said Robilotti, who is executive vice president of Danbury (Conn.) Health Systems, parent of 371-bed Danbury Hospital.
Robilotti said traditional Medicare is more "secure" in that it can't withdraw from a market. Some HMOs have pulled out of unprofitable markets in recent months, and beneficiaries have had to switch to another Medicare HMO, if available, or revert to traditional Medicare coverage.
The campaign, including a series of newspaper ads that ran last fall, is expected to cost less than $200,000 and is funded by a special assessment of the membership, said association spokeswoman Deborah Hoyt.
She said Connecticut has 507,000 Medicare beneficiaries, 105,063 of whom are enrolled in HMOs.
The brochures were mailed to households with Medicare beneficiaries and women age 46 and older. The latter group was sent brochures because the association believes many seniors consult their female children for healthcare advice.
Robilotti said MedSpan, a provider-owned HMO based in Hartford, Conn., expressed concern that the campaign would bash HMOs. Calls to MedSpan officials were not returned.
Last year, a HCFA regional administrator reprimanded a North Dakota hospital for conveying misinformation about Medicare to consumers (Dec. 14, 1998, p. 12). However, regulators in the Northeast have not found fault with the campaigns in their jurisdictions.
David Banks, spokesman for the HCFA Region 1 office in Boston, said officials were aware of the Connecticut campaign, but they determined that it had no jurisdiction. "They can basically do whatever they want as long as they don't make false statements," Banks said.
In contrast, Medicare HMOs must have their marketing materials approved by HCFA.
Mark Rosenblatt, senior vice president of National Health Resources, a management company for North Shore Physician Organization, said Berek recently cleared the physician organization's campaign.
"They determined that they had no jurisdiction over the North Shore Physician Organization and found that there wasn't any problem with our ad campaign," Rosenblatt said.
Berek did not return several phone calls.
Rosenblatt said North Shore is preparing a new round of newspaper ads and tabletop displays in physician offices, to be unveiled by early summer.