Episode 15

Medicare Advantage (MA plans) - a deep dive with Michael Hughes


October 12th, 2020

1 hr 4 mins 51 secs

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About this Episode

Dr. Amy Schiffman and Dr. Alex Mohseni interview Michael Hughes, principal at Mitchell-Lowey, LLC, and do a deep dive into Medicare Advantage plans, especially as they relate to supplemental benefits like private duty home care services. We discuss:
What is Medicare Advantage
MA plans offer supplemental benefits
CMS is realizing that SDOH determine health and cost outcomes
Who costs the system the most
Examples of supplemental benefits include things like home care and pest control
How many MA plans are there
SSBCI - special supplemental benefits for the chronically ill
How does an MA plan measure effectiveness of supplemental benefits
How do physicians order supplemental benefits for members
VBID model
Conversion rate from MA plan to private pay
What are the downsides of choosing an MA plan
Why MA plans care about the quality of supplemental benefits
MA plans as a percentage of total Medicare population by state (Link)
Link to Michael Hughes: https://www.linkedin.com/in/michael-hughes-7010221/
Video version: https://www.youtube.com/watch?v=7NrtiqkkHtQ