Back in the 90’s, when I was launching the Medicare Rights Center, AARP partnered with United Healthcare to offer standardized Medicare supplemental insurance policies for people in traditional Medicare. Since then, AARP has partnered with UnitedHealthcare to support its private Medicare Advantage plans. Now, Fred Shultz reports for Kaiser Health News, that AARP is now partnering with Oak Street Health, which operates health clinics in more than 20 states. Can you trust AARP when it comes to choosing a Medicare Advantage plan or using a health clinic?
Make no mistake. AARP, a non-profit trade association for older adults, is partnering with health insurers and health clinics in order to generate hundreds of millions of dollars in income. If AARP had meaningful data to assess and choose partners offering high quality products and services, its partnerships could add value for its members. But, no one has that ability because the data is not available.
AARP’s partnerships with UnitedHealthcare and Oak Street are all about the money, pure and simple. And, therefore you cannot trust the AARP name when it comes to deciding whether you should join a Medicare Advantage plan operated by UnitedHealthcare or visit a health clinic operated by Oak Street. AARP is generating $1 billion a year from these partnerships. Talk about conflicts of interest.
As it turns out, Oak Street is under investigation by the Justice Department for possible violation of the False Claims Act because of its marketing practices. Naturally, Oak Street denies any wrongdoing, and it claims it offers “value-based care.” I say, “no data, no value.”
Oak Street is one of the 99 “direct contracting entities” that the Centers for Medicare and Medicaid Services (CMS), the agency that oversees Medicare, has contracted with as part of an experiment intended to reduce Medicare spending and improve quality of care for people in traditional Medicare. But, the experiment injects for-profit middlemen into traditional Medicare that show no evidence of delivering value as I and many others have argued.
As health economist Marilyn Moon explains, these partnerships put AARP in a compromising position. These partnerships are very different from AARP partnering with a travel company to help its members get travel discounts. The partnerships could keep AARP from advocating to promote the needs of their members.
For example, because of its partnership with Oak Street, AARP does not appear to have spoken out against the privatization of traditional Medicare through direct contracting entities, renamed REACH. REACH is a government experiment in which Oak Street and other private equity and insurer entities are paid to “manage” care for people in traditional Medicare.
AARP claims that its partnerships do not affect its advocacy on behalf of its members. Even if that were true, the appearance of a conflict in and of itself is troubling.
Here’s more from Just Care:
- Beware of researchers with conflicts of interest
- Are disease groups industry fronts?
- DCE experiment could mean total privatization of Medicare
- United Healthcare cuts costs and jeopardizes access to specialty care.
- Aetna under investigation for denying care without appropriate review of medical records
AARP has lobbied Congress to end Medicare coverage of certain medical procedures. This allowed their executives to be even more overpaid than they already were.
AARP is a greedy, predatory business, posing as a non-profit organization.
Thank you for this informative insight into some of its sleazy practices.
Is it supposed to be obvious who/what CMS is? I looked in the article for the name spelled out but dont’ see it & I understand from h.s. journalism class that the first time you refer to an organization, known by initials, that you first spell it out.
My apologies. I have edited the post. CMS is the Centers for Medicare and Medicaid Services, the government agency that oversees Medicare.
Your organization is too biased in favor of original Medicare, which has limited payments of medical bills, with no cap on how much the beneficiary might have to pay. The idea that all seniors can afford a Medicare supplement plan is false. These supplement plans with original Medicare leave seniors on fixed incomes with not being covered for and being able to afford eye exams and updated glasses, which have become obscenely expensive. People cannot see without glasses or contacts. Lasix surgery is expensive, still might require glasses in some cases, can sometimes have side effects, and can change and revert back to imperfect, blurry vision. Dentistry has always been expensive, and has gotten more expensive over time. There are some dentists who have been found to be dishonest. I have not seen these uncovered area mentioned by your organization. If seniors have no coverage, they would forgo care. Supplement plans require that a prescription drug plan be purchased on top of Medicare and a supplement plan. The idea that low-income seniors automatically are eligible for financial assistance programs regarding Medicare is not true. Even with HUD housing assistance, an older person could still end up not being able to afford to pay the percentage of rent that is required, or could pay the rent but may be unable to afford prescribed drugs or to pay for doctors’ charges, diagnostic tests, treatments, or increasingly expensive hospital bills. If someone’s assets are taken away due to medical debt, they might not have transportation or housing. The mental health system is broken and is often not “comprehensive.” Many providers are inadequately trained. Irrelevant questions are often asked by agencies which do little or nothing to help the client, and you may have to use insurance and pay a co-payment just to be asked a bunch of mostly ineffective or meaningless questions by someone who could care less how you answer the questions. If someone has unmet needs or cannot function anymore living alone, the resources are not that likely available to keep some living in the community and having a place to live and being taken care of. Mental health agencies are quite bureaucratic, and the state and federal governments have no real quality standards of care and oversight.
Agree 100%
Daniel — All those problems and more exist w/ the Advantage plans. They notoriously deny care and any charges they don’t extend coverage to do not go against any out-of-pocket maximums. I ended up paying over $40K out of pocket after a major accident caused a badly broken leg w/ treatment extending over two calendar years. Luckily I was able to switch back to original medicare and a supplement after that fiasco was over — and have had significantly lower medical costs annually ever since. The advantage plans are only an advantage to the private insurers and anyone lucky enough not to need medical care. And yes, the problems you mention are abundant in our broken US medical system — they’re just worse if you buy into the advantage plans.
You are completely correct that traditional Medicare has become extremely expensive for anyone who needs to buy supplemental coverage. We have been advocating for Congress to enact legislation that puts an out-of-pocket cap in traditional Medicare, as Medicare Advantage has.
That said, if you need costly health care in Medicare Advantage, your out-of-pocket costs can easily be twice as much as your costs in traditional Medicare with supplemental coverage. Moreover, you can face serious administrative and financial obstacles to care and might not be able to see the doctors or use the hospitals you want to use. These are all serious problems with Medicare Advantage. Anyone who enrolls with limited incomes is taking a gamble that they will be able to get the care they need if they become seriously ill. In addition, some Medicare Advantage plans are far better than others, but the government doesn’t share that information with you. So, you could be choosing a plan that inappropriately denies care routinely and not know it.