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Private Fee-For-Service Medicare Plans Raise Questions About 'Long-Term Direction'

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Fee-For-Service Medicare Plans

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The Boston Globe on Wednesday examined private fee-for-service Medicare Advantage plans in Massachusetts. According to the Globe,while private fee-for-service plans expanded nationwide in 2003, theywere not offered in New England until January. The plans may offer morebenefits than traditional Medicare and do not limit beneficiaries tocertain physicians or require them to obtain a referral to seespecialists as in private managed care plans.

However, the plans"raise questions about the long-term direction of Medicare because theycost more than traditional coverage but are not held to higher qualityand efficiency standards," the Globe reports. In addition, according to the Globe, CMS officials maintain that the "growing popularity of the privatefee-for-service plans has also been marred by aggressive and impropersales tactics." Harvard Pilgrim Health Care this year switched all of its Medicare coverage to private fee-for-service plans, and Tufts Health Plan and Blue Cross and Blue Shield of Massachusetts will begin promoting such plans in 2008 (Krasner, Boston Globe, 10/24).

Reprinted with permission from kaisernetwork.org. Youcan view the entire Kaiser DailyHealth Policy Report, search the archives, and sign up for email deliveryat kaisernetwork.org/email. The Kaiser Daily HealthPolicy Report is published for kaisernetwork.org, a free service of The HenryJ. Kaiser Family Foundation. 2007 Advisory Board Company and KaiserFamily Foundation. All rights reserved.