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Competitive bidding for Medicare Advantage (MA) plans is no longer a long-shot concept of a few key senators. It is being pushed by the Obama administration and is now an integral part of the Senate Finance Committee’s health reform bill. No one should be surprised if it survives a House-Senate conference committee and becomes law. Were that to happen, the entire MA climate would change dramatically. Winners and losers under competitive bidding would depend on a variety of factors, including geography and the impact of “grandfathering” provisions for current MA members that could make it into the final legislation. MA organizations wanting to assure their continued viability in a tougher competitive-bidding environment have lots of complex variables to sort out quickly. Those include the composition of their current and future membership, the impact of Medicare Advantage competitive bidding on revenues and benefit design, and the key offsetting role of the new proposed quality bonus payments for MA plans. Already hard-pressed Medicare Advantage Special Needs Plans apparently would not have an exemption from competitive bidding and would need to take special precautions to survive it. Get valuable practical insights from two leading Medicare managed care experts with decades of successful experience. You’ll find out:
STEPHEN P. WOOD is a Chicago-based senior vice president of Ingenix Consulting and is responsible for its Government Programs Management and Strategy practice. His experience in senior markets dates back to the mid-‘80s and includes work with many insurers serving that market to review and develop strategies, conduct new-product feasibility assessments, and improve programs. From 1995 to 2003, he was a principal with Tillinghast-Towers Perrin, where he led the firm’s senior services practice. Before that, he was the managing director of strategic consulting services at the Blue Cross and Blue Shield Association. A 2009 Consulting Magazine ‘Top 20’ consultant, Mr. Wood is a graduate of the University of Chicago and holds a masters degree from its Harris School of Public Policy. KIRK TWISS is vice president, actuarial consulting in Ingenix Consulting’s Chicago office. He specializes in actuarial services related to the financial risk of managed care organizations. A consultant in the managed care arena for more than 20 years, he spent the majority of that time with Bob Gold and Associates and later was with Ernst & Young. Mr. Twiss became a Fellow of the Society of Actuaries in 1985 and a member of the American Academy of Actuaries in 1983. He has a bachelor of arts degree from Cornell University and an M.B.A. from the University of Michigan. Moderator: Jim Gutman, vice president and executive editor at Atlantic Information Services, Inc.
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