HCFA faulted for sitting on benefits data
The Health Care Financing Administration (HCFA) has been chided by another government agency for not doing enough to inform Medicare beneficiaries about their benefits and options.
A report from the General Accounting Office says HCFA already compiles much of the data internally but does not provide enough of it to beneficiaries to help them select their options. This has not been a "front-burner" issue in the past because most Medicare recipients were on the same fee-for-service plan, the report says. But with more than 4 million beneficiaries enrolled in Medicare managed care 90% of them in risk-based arrangements it has become more important that recipients be able to pick and choose among the various plans and options available to them.
"HCFA amasses volumes of information that could be packaged and distributed to help consumers choose among competing Medicare HMOs," the report says. It specifically notes that the agency compiles for internal use information on HMO plans’ premium requirements and benefit offerings. Those data could be turned into comparison charts to help beneficiaries more easily determine which plan they want to enroll in, it says.
The report says the most useful data HCFA could offer would be on disenrollment rates among the various plans. Such information can be used as a gauge of satisfaction. The General Accounting Office conducted its own analysis of HCFA disenrollment data in Miami and Los Angeles and found wide variations in satisfaction.
"For example, nearly one in three Medicare applicants either canceled or left Miami’s CareFlorida within the first three months, whereas only one in 10 of Health Options’ or Prudential Health Care’s Medicare applications left this early," the report says.
The report specifically recommends three improvements by HCFA:
• standard formats and terminology in HMOs’ information materials;
• benefit and cost comparison charts for all Medicare HMO options available in each market;
• wide distribution of HMOs disenrollment rates, complaint rates, and summary results of HCFA’s site monitoring visits.
For a copy of the report, titled Medicare Should Release Data on HMOs, call the General Accounting Office. Telephone: (202) 512-6000. One copy of the report is free and additional copies are $2 each.
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