ChristianaCare, Bayhealth and Highmark Blue Cross Blue Shield Delaware hope to offer an Medicare Advantage plan for Delawareans in 2022, pending approval from the U.S. Centers for Medicare & Medicaid Services (CMS).
Medicare Advantage, a government Medicare plan offered by contracting with private companies, has been touted as a rapidly-growing option for senior citizens that also reduces health care costs. If approved, the agreement will mark the first time ChristianaCare and Bayhealth have worked with a health insurance company to offer such a plan to eligible Delawareans.
“ChristianaCare and Bayhealth are prominent health care providers in the areas of care coordination and outcomes, and they have strong ties to their communities. This collaboration will help increase access to care, enhance the provider-patient experience, and make way for new solutions to improve health for all seniors,” said Alexis Miller, market president of federal markets with Highmark Blue Cross Blue Shield Delaware.
Both ChristianaCare and Bayhealth officials declined to comment on what the Medicare Advantage plan may offer residents — or to what degree its potential savings would look like — until the plan is approved by the federal agency.
“We are excited to offer Medicare Advantage because it aligns with our commitment to continuously look for ways to innovate and provide the highest quality of care to everyone we serve,” ChristianaCare Chief Population Health Officer Christine Donohue-Henry said. “Participation [will offer] patients with excellent care with affordable and predictable out-of-pocket costs and enhances care coordination, preventative care and care for chronic conditions.”
With trends showing that Medicare Advantage grows more appealing each year, more hospitals and health systems across the country are pushing away from a fee-for-service model and more toward funding patient outcomes. The CMS reports that 25 million Americans enrolled in Medicare Advantage in 2020, roughly 40% of all Medicare beneficiaries.
As the population continues to age, the Congressional Budget Office projects that figure will rise to 51% by 2030.
Medicare Advantage offers benefits like vision and dental programs, disease management and other wellness programs. Other plans may opt to cover benefits such as transportation to doctor visits, over-the-counter drugs and more.
Enrolling in Medicare Advantage may save patients money as well. A recent study from insurance giant UnitedHealth Group and the consulting firm Milliman found that those enrolled in the plan save an average of $2,000 a year, or 40%, compared to traditional Medicare.
ChristianaCare estimates that 48% of its patient base is enrolled in Medicare, while Bayhealth estimates its number at 50%. Delawareans ages 65 and younger may pay an estimated $1,727 to $2,005 more than Medicaid Advantage, according to the UnitedHealth Group study.
One disadvantage that Medicare Advantage has is that its patients may have fewer options in terms of medical providers, as insurance companies may use a narrow window to meet the criteria. Both ChristianaCare and Bayhealth officials point out that many patients are already treated by physicians, and Medicaid Advantage will just improve access to care.
“We are working together with local health care partners to ensure access to efficient, affordable, and high-quality care for Delawareans, especially vulnerable populations like seniors. Serving individuals and the community is fundamental to our mission at Bayhealth,” Bayhealth Senior Vice President and Chief Medical Officer Gary Siegelman said in a prepared statement. “We believe this collaboration is important, because it will support better coordination of care and increase our ability to help seniors manage their chronic conditions, so they can enjoy the important people and activities in their lives.”
