Journalists should always explain differences between Medicare & Medicare Advantage
You can’t assume that readers/viewers know the difference
UnitedHealth Group - one of the biggest sellers of for-profit Medicare Advantage plans - was in the news last week but with a special twist in the Minneapolis metropolitan area.
It was national news when a study showed that UnitedHealth Group and two other for-profit competitors in the Medicare Advantage market were found to deny patients’ requests for coverage of post-hospital care at much higher rates than other insurers - 51-80% of the time.
The Minnesota Star Tribune also reported:
A related study published Thursday questioned whether a UnitedHealth Group subsidiary (naviHealth) has been wrongly delaying or denying access to care by initially rejecting a high number of patient requests for admission to skilled nursing facilities, only to later overturn almost all decisions when patients appealed.
The new findings fit with long-standing concerns that the health care giant has grown and profited, in part, by systematically slowing or blocking payments for necessary care. The company has strenuously rejected that claim, attributing its success to diversification beyond health insurance into services like running clinics and managing pharmacy benefits.
What became big local news in the Twin Cities was when the Minneapolis-based Fairview Health Services system announced:
The Star Tribune reported:
In email messages sent Thursday to about 11,000 patients, Minneapolis-based Fairview cited ongoing problems with coverage changes, denials and payment issues with UnitedHealthcare, the nation’s largest health insurer.
The same newspaper reporter who did a good job on those stories was invited to appear on the popular Twin Cities Public Television Friday evening Almanac program.
One of the Almanac anchors asked:
“UnitedHealthcare - their Medicare patients are going to be cut off from Fairview? What’s that about?”
(This portion of the segment starts at 3:50 deep in this video.)
The newspaper reporter, in my opinion, should have immediately corrected or clarified that question by emphasizing that these were Medicare Advantage patients, not traditional Medicare patients. Moments later, he mentioned Advantage plans only once, but not with any context about the important differences in the two types of senior coverage.
The segment ended when one of the anchor’s summary comments was:
“Well if you’re a Medicare patient, it’s really hard to know what to do around here.”
The segment didn’t make it any easier to “know what to do around here” by not distinguishing the two types of Medicare.
The differences between the two types of Medicare plans were spelled out in this New York Times article:
Seniors and all taxpayers should care that the nonpartisan Medicare Payment Advisory Commission stated in a report to Congress in March:
We estimate that Medicare will spend 14 percent—a projected $76 billion—more for (Medicare Advantage, or) MA enrollees in 2026 than it would spend if those beneficiaries were enrolled in (traditional) Medicare. … The Commission contends that important reforms are needed to improve Medicare’s policies of paying and overseeing MA plans.
The American College of Physicians is also pushing Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services, to get tougher on oversight of Medicare Advantage plans.
The report touches on fraud (supposedly one of Oz’s pet issues), deceptive marketing practices, “hidden expenses that add up quickly,” and many other issues.
But this comes at a time when Oz is considering a plan that would automatically enroll beneficiaries into Medicare Advantage plans.
That’s just a short list of the concerns about Medicare Advantage plans.
So - getting back to my analysis of the TV segment on Fairview Health Services cutting off Medicare Advantage plans - this is why, in my opinion, it’s important to either take the time - every time - to explain the difference between the two types of Medicare plans, or else don’t report on them at all.
Of course, there’s a widespread difference between writing about this with an editor’s oversight in print/digital versus going on live TV to discuss this.
Let me be clear: I’ve always been a big fan of the local PBS station’s Almanac program. It does a terrific job reporting on local politics and many other issues.
The anchors are knowledgeable veteran journalists. The Star Tribune newspaper reporter who appeared on the program last Friday is a knowledgeable veteran health care journalist. But two things went wrong:
If the anchor had simply asked, “What’s up with Fairview cutting off UnitedHealth Group’s Medicare Advantage coverage?” instead of asking why “their Medicare patients are going to be cut off,” the segment may have been OK.
If the Star Tribune reporter had simply corrected/clarified that the focus of her question was about Medicare Advantage only - not traditional Medicare, I wouldn’t have written this long piece.
My summary
I don’t believe that this is trivial nitpicking. Medicare Advantage plans have raised concerns with many health policy experts. It’s important to get this right. Here are just three recent articles I’ve published:
One problem may be the growing trend of TV news/info/analysis programs inviting as guests knowledgeable print reporters who are not experienced in live TV, who are then interviewed by TV anchors who can’t be expert about everything - like, in this case, the important differences between the two types of Medicare plans. The live TV segment may take a brief wrong turn with a misstated question, the print reporter is out of his element and doesn’t jump in and offer a correction. As a result, viewers may be misled about what the news really is.
I have written to the local PBS station about this. I have suggested that they host a segment dedicated solely to a balanced, independent analysis of the key differences between these types of plans.
Gary, you are so right about this, I can't believe how many people I talk to, from patients to friends and family members, who don't understand the difference. I've been trying to inform people I know about this for years, but I feel like a tiny salmon swimming upstream against the enormous current of the private insurers' advertising campaigns to promote their MA plans!
I am so glad that I chose traditional Medicare plus a robust supplemental policy when I retired 10 years ago. Except for physical therapy, I’ve never had to get a referral for anything and everything, including a hip replacement and two visits to ER, one in an ambulance (a botched chiropractor visit) have been paid 100%. Compared to my husband’s Advantage plan which he chose because his pension pays a portion of it, with its long waits for referrals, “generous” co-pays, etc., if I’d been covered under his policy, my expenses would have been much more than what I pay for Medicare and the supplemental policy each year.