Brace for Change: What's Happening with Medicare in 2019?

September 25, 2018
Panelists Jim Eppel, Kimberly Halva, and Ghita Worcester

Without question, the Medicare market is changing. More than 300,000 Minnesotans will be impacted when a federal law eliminates certain health insurance options in the Twin Cities and across much of the state. Beginning in 2019, coverage for Medicare Cost plans will end throughout the nation, disproportionately affecting Minnesotans, who constitute more than half of the total enrollees. Our panel of experts weighed in on the impending changes – read on for the insights from Jim Eppel of HealthPartners, Kimberly Halva of Fairview, and Ghita Worcester of UCare.

Combating Confusion

  • Most Medicare enrollees would be unlikely to know whether they belong to a Cost or Advantage plan. The information they receive across different sources, including email, direct mail, commercials, and online, has a tendency to be confusing and, at times, contradictory.
  • It’s important to approach the changes from both a patient and delivery side. The Minnesota healthcare industry’s effort should be focused on getting members information to help them work through the transition.

Changing Populations

  • The Medicare population is not a homogenous market. One 65 year old is not the same as the next and cannot be treated in the same manner. Past generations looked to nylons and canes to usher in their Medicare years, while today’s generation is attempting to squeeze in a knee replacement surgery before a big ski trip.
  • The tailoring required for this demographic is immense and made more challenging with limited funding and greater expectations.
  • Perhaps the most worrisome group is the vulnerable population. It’s very difficult for people on specialty medications to transition to a new care provider.

Positive Impacts

  • Minnesota is disadvantaged from a funding side, considering we have no chance to siphon money from Texas or Florida, but moving to the Advantage product gives our state the ability to impact public policy in a way that is advantageous.
  • The entrance of national plans in the Medicare market is a shift, but competition is always positive for consumers. It will make everyone sharper, better, and more focused.

Closing Thoughts

Member satisfaction will almost certainly take a hit in the next year. Despite our best efforts, people will be confused and unhappy about the implications of Medicare Cost plans going away. While it will be difficult to educate members and endure the transition process, consumers are hungry for information and eager to learn more. The ultimate challenge will be figuring out how to make the new system work without undermining the process publicly and giving way to a media frenzy.

Extra Credit

Medicare Enrollment Dashboard. The Centers for Medicare & Medicaid Services provides an interactive enrollment dashboard showing trends across geography and time.

What’s Happening to My Medicare Cost Plan? HealthPartners provides a quick summary of what’s happening with Medicare Cost plans and how it impacts enrollees.


Recommended Sessions

All Previous Sessions
Bringing together the brightest minds in healthcare to educate, discuss, and challenge one another.