Medicare HMO and PPO members in 25 major and midsize cities can expect significant out-of-pocket savings this year -- sometimes in the double digits -- thanks to the Medicare reform law, according to a survey by HealthMetrix Research, Columbus, Ohio. The Medicare Modernization Act of 2003 increased payments to Medicare health plans by an average of 10.9% per enrollee as of this March. The survey of more than 50 Medicare plans found that most had opted to pass along the savings to members by cutting monthly premiums and copayments or enhancing prescription drug benefits. As a result, out-of-pocket costs should drop to below 2003 levels for healthy members in 80% of plans and for members with chronic conditions in 62% of plans, HealthMetrix said. In general, provider-sponsored plans are passing on less savings to members, suggesting they intend to spend more of the additional Medicare revenue on strengthening provider networks. "Beyond the immediate dollar savings, the findings suggest that HMOs and PPOs are serious about restoring good will with their members that was badly damaged from the effects of benefit cutbacks, increased cost-sharing and market withdrawals since 1998," said HealthMetrix President Alan Mittermaier. View the survey results. -- by Laura B. Benko
Costs to fall for Medicare managed-care enrollees
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