Medicare managers take heat on Hill

Starting next year, the Health Care Financing Administration will require Medicare managed care plans to present information about their benefits in a standardized format, similar to the one used for the Federal Employees Health Benefit Plan, HCFA Deputy Administrator Michael Hash told the Senate Finance Committee today. To the extent possible, plans will also have to use standardized language so beneficiaries can better compare them, Hash said. But that was about the only news from HCFA panel members wanted to hear. For much of Hash's appearance, senators heaped criticism on HCFA for the way it is handling the implementation of the complicated Medicare+Choice program enacted in last year's Balanced Budget Act.

Hash took particular fire for HCFA's last-minute decision not to launch its beneficiary education program nationwide, but to limit it to five states. "I am extremely disappointed at the lack of action this year," Finance Chairman Roth said. Roth said the eight-page newsletter most beneficiaries will receive in lieu of the larger Medicare handbook "raises more questions than it answers."

But Hash defended the decision not to proceed with the larger handbook and toll-free information line for the program's 39 million beneficiary population. Based on recommendations from outside experts and focus groups, Hash said, "We felt like a more full evaluation, not just of the handbook, but of the whole educational program, was required."

Meanwhile, the Blue Cross/Blue Shield Association told the committee that HCFA's information requirements for quality improvement would basically force from the market more loosely organized "Preferred Provider Organizations," and could raise costs for health maintenance organizations to the point where they would have to drop additional benefits that make them popular for Medicare beneficiaries.

"Broad access PPOs are simply not set up to monitor, measure, and assure improvement in enrollees' health status and physician outcomes," testified Daniel Lestage, vice president of Blue Cross/Blue Shield of Florida. And while HMOs could gather the required information, Lestage said, he questioned the merit of the requirements.

"Spending precious resources on activities of dubious value to beneficiaries will only take dollars away from things that do matter to beneficiaries, such as added healthcare benefits," he said.