Medicare is a national health insurance program in the United States, begun in 1966 under the Social Security Administration and now administered by the Centers for Medicare and Medicaid Services (CMS). It primarily provides health insurance for Americans age 65 and older, persons with disability status as determined by the Social Security Administrations, as well as people with end stage renal disease and amyotrophic lateral sclerosis.
On September 12, 2013, the Centers for Medicare & Medicaid Services (CMS) announced a new partnership with the State of Minnesota to test new ways of improving care for Medicare-Medicaid enrollees. Building on the state's Minnesota Senior Health Options (MSHO) program, CMS and Minnesota will work together to improve the beneficiary experience in health plans that maintain contracts with both CMS as Medicare Advantage Special Needs Plans and with the state to deliver Medicaid services.
Original Medicare does not limit out-of-pocket costs, so most enrollees maintain some form of supplemental coverage. Nationwide, more than half of Original Medicare beneficiaries get their supplemental coverage through an employer-sponsored plan or Medicaid. But for those who don’t, Medigap plans (also known as Medicare supplement plans, or MedSupp) will pay some or all of the out-of-pocket costs they would otherwise have to pay if they had only Original Medicare.
Private managed care programs for Medicare beneficiaries are particularly popular in Minnesota. Fifty-six percent of all Minnesota Medicare enrollees were enrolled in private Medicare plans in 2017, as opposed to a national average of 33 percent. Minnesota has by far the largest share of its Medicare population enrolled in private plans; the next closest state is Hawaii, where 45 percent of Medicare beneficiaries have private coverage.
Since 1997, Minnesota has provided Medicare coverage for approximately 35,000 Medicare-Medicaid eligible individuals over age 65 through the Minnesota Senior Health Options (MSHO) program. Today, the Minnesota demonstration recognizes this program stability and is focused on administrative flexibility rather than developing a new capitated system. The current demonstration will be evaluated for its ability to further promote integration. However, the longevity of the MSHO program provides for unique data analysis opportunities. MSHO claims data are a rich resource for researchers to analyze the impact of integrated care on health care outcomes for Medicare-Medicaid eligible. To that end, the Office of the Assistant Secretary for Planning and Evaluation (ASPE) published Minnesota Managed Care Longitudinal Data Analysis which highlights the importance of providing integrated options for Medicare-Medicaid eligible individuals. It may be found at this link: https://aspe.hhs.gov/report/minnesota-managed-care-longitudinal-data-analysis
‘This year will be different’ OCTOBER 1, 2019 WRITTEN BY JIM PALMER Medicare made simple! Breitenfeldt Group provides service, selection all in one place “This year will be different,” said Dennis Breitenfeldt, owner of Breitenfeldt Group, referring to the big changes in Medicare last fall that resulted in 400,000 Minnesotans losing their coverage. “A lot of people lost their plans last year and… READ MORE >