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Tag: Costs

  • Private equity buying up specialists and driving up health care costs

    Private equity buying up specialists and driving up health care costs

    Reed Abelson and Margot Sanger-Katz report for The New York Times on private equity’s growing role in health care. The New York Times story is based on a new report from the Antitrust Institute finding that private equity is buying up specialist practices and driving up health care prices and expenses in the process.

    Private equity sees big dollars in health care and is paying big money to own physician practices all over the country, at a rapid rate. In 13 percent of the country, private equity owns more than 50 percent of physician practices, which means higher costs for everyone. In markets with the highest private equity penetration, health care costs are rising most dramatically. In cases where private equity controlled more than 30 percent of the market, gastroenterology, dermatology, and obstetrics and gynecology costs rose by double digits.

    Private equity firms appear to see value in owning many, if not all, physician specialists as well as primary care practices. Private equity firms have focused on urology, ophthalmology, cardiology, oncology, radiology and orthopedics. Once they have a solid share of the specialty market they demand higher prices from insurance companies.

    Insurance companies, in turn, must pay these private-equity owned practices higher prices in order to have enough specialists in their networks. And, if insurance companies are paying more, you better believe that your health insurance premiums are rising, along with deductibles and copays.

    Thankfully, Traditional Medicare has fixed provider rates. But, if Medicare Advantage takes over Medicare, (as it will likely do if Congress does not act soon,) Medicare Advantage plans will not have the leverage to negotiate Medicare rates and costs will rise dramatically in Medicare Advantage.

    Alternatively, the federal government could require Medicare Advantage plans to pay Medicare rates. The private equity-owned practices would likely have to honor those rates to ensure they have enough patients. The Medicare population tends to make up a significant portion of specialists’ patients.

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  • As the US population ages, how will people afford long-term care?

    As the US population ages, how will people afford long-term care?

    Americans are finding it increasingly difficult to meet their and their loved ones’ long-term care needs. Congress continues to sit on its hands, while some states are taking action. Mark Miller writes for the New York Times about the need for Congress to step in on behalf of all Americans who could need long-term care and, in the meantime, what some states are doing to help their residents.

    The vast majority of Americans will need some kind of long-term care as they age, be it help with bathing, dressing and toiletting, other activities of daily living, or full-time home care or nursing home care. Only about one in five Americans will not need long-term care. For now, there’s no hope of Congressional action, as ensuring people’s long-term care needs are met costs money, and Republicans have taken raising taxes to cover additional healthcare costs off the table.

    The average cost for one year of nursing home care was nearly $110,000 two years ago. Yet, nearly seven in ten Americans have done little if any planning and saving to cover the costs of their long-term care needs. Not even one in six Americans believe they are prepared financially, if they need long-term care. Those who are unprepared will likely have to count on family and friends to volunteer their time to care for them, if they do not qualify for Medicaid.

    Medicaid does cover long-term care. It is an invaluable benefit. But, in order to get Medicaid, your income and assets need to be extremely low. Thankfully, in many states, if your income and assets are above the eligibility level, your health care expenses can bring your income and assets down to the Medicaid eligibility level so you can qualify for Medicaid.

    Most people do not realize that Medicare does not cover long-term care. At best, people might qualify for 100 days of nursing home care, but that’s only if they’ve been hospitalized for at least three days in the 30 days prior to admission in a nursing home. And, people in Medicare Advantage plans rarely get coverage for more than a very short nursing home stay. People also might qualify for very limited Medicare-covered home care, and that’s only if they’re homebound and need either intermittent skilled nursing or therapy services.

    Washington State is the first state to launch its own publicly-administered long-term care program, the WA Cares Fund,  States such as California and Minnesota might do the same in time. The issue is that covering long-term care is not only expensive, but tricky to implement.

    In Washington State, long-term care benefits will be available to everyone beginning in 2026, and everyone will pay in for those benefits during their working lives through a 0.58 percent payroll contribution. The maximum benefit will only be $36,500, a fraction of the total amount most people will need to spend on home care. The Washing State benefit should help with a year of home care costs.

    Washington State might save on Medicaid expenses through this long-term care program. That’s what the state is hoping. Because of the program, some people will not need to spend down all their assets to qualify for Medicaid. But, nothing is clear at this point.

    Some questions still need to be answered. For example, what if people also have private long-term care insurance? And, will people who contribute to the program lose their right to benefits if they move out of Washington state?

    All this said, Washington State is doing its residents a major service. Private long-term care insurance has always been a gamble, with “level” annual premiums able to double out of nowhere; it becomes increasingly unaffordable over time and offers benefits that are generally more limited than people realize.

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  • Merck sues Medicare over negotiated drug prices

    Merck sues Medicare over negotiated drug prices

    Merck just filed a lawsuit challenging the legality of the Inflation Reduction Act‘s provision allowing Medicare to negotiate some drug prices with pharmaceutical companies. The administration is holding firm to doing so, notwithstanding. The law is intended to lower drug prices in Medicare.

    Merck claims that if negotiated drug prices take effect, it will keep drug manufacturers from innovating new drugs. It wants a court to say that it does not have to take part in drug price negotiations with the federal government. If the issue is innovation, the question becomes how much profit do the pharmaceutical companies need to generate to ensure they innovate and innovate for drugs that we need. Last year, Merck profited $14.5 billion.

    In response to the lawsuit, Secretary of Health and Human Services Xavier Becerra said, “We’ll vigorously defend the President’s drug price negotiation law, which is already lowering health care costs for seniors and people with disabilities. The law is on our side.”

    The IRA drug price negotiation provision is not set to take effect for another two and a half years. And, in its first year, only 10 drugs that have been on the market for several years without competition will have lower negotiated prices.

    Merck is claiming the drug price negotiation law is unconstitutional because it is taking of property for the public without fair compensation. In this country at this time, Merck could win. But, the law is not on Merck’s side.

    The IRA drug price negotiation provision is designed to withstand constitutional challenges. It allows Merck to turn down Medicare’s final negotiated price. Merck would then be subject to a tax. But, the tax could end up being hundreds of millions of dollars a day over time, according to Merck’s complaint.

    We still don’t know which drugs are included among the 10 the government intends to negotiate prices for in 2026. But, one of Merck’s drugs, Januvia, which some diabetes patients use, could be among them. And, in future years, another Merck drug, Keytruda, which some cancer patients use, could be another.

    Public Citizen President Robert Weissman issued the following statement:

    “Merck is claiming the U.S. constitution requires the U.S. government and people to be suckers. That’s not true.”

    “There’s no Sucker Clause in the 1st Amendment, 5th Amendment, or anywhere else in the Constitution.”

    “This lawsuit is a desperate attempt by the industry to beat back popular legislation that would curtail Big Pharma’s ability to price gouge Medicare and secure monopoly profits. Full stop.”

    “While Big Pharma’s litigation gambit plays out, it is critical that the federal government continue its preparation for price negotiations. Delay in the commencement of long overdue negotiations will result in billions of dollars in excess costs for taxpayers and consumers.”

    Touche!

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  • Medicare patients with liver cancer face $10,000 in out-of-pocket costs

    Medicare patients with liver cancer face $10,000 in out-of-pocket costs

    Even with Medicare, out-of-pocket costs for people with liver cancer can be unaffordable. A recent study found that Medicare patients must spend $10,000 out of pocket for medical and hospital care in the first year of treatment. When will Congress focus on bringing down out-of-pocket health care costs?

    About half of people with liver cancer are diagnosed after they go on Medicare. Still, the costs of liver cancer are substantial. Enormous debt and sometimes bankruptcy are likely consequences of liver cancer for people with Medicare. A study author explains that “Financial toxicity of cancer therapy can negatively impact patients, resulting in medical debt and even bankruptcy for some patients.”

    What does Medicare cover? If you have liver cancer, Medicare pays for medical services, hospital care, prescription drugs, hospice care and sometimes also physical therapy, home health care and skilled nursing facility care. But, it does not cover the full cost of your care.

    New treatment options, including new surgeries, radiation-based therapies, thermal ablation, which uses heat to kill the cancer, and immunotherapies, can be very effective. But, they all come with significant costs. And, costs have been increasing significantly since 2015, the most recent year studied.

    The study compared costs for patients with cirrhosis with costs for patients with liver cancer. Costs for cirrhosis patients were much lower than the costs for patients with liver cancer. Patients with liver cancer need additional financial help.

    This study did not look at prescription drug costs for liver cancer patients with Medicare. These drug costs only add to people’s financial burden.

    More people are dying with liver cancer because it often is not detected until late stage. By 2040, liver cancer is predicted to be the third-leading cause of death from cancer.

    In the US, cancer treatment is stunningly expensive. It is expected to rise to $250 billion in 2030.

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  • Get ready for more prescription drug price hikes

    Get ready for more prescription drug price hikes

    We know pharmaceutical companies are greedy. Most, if not all, companies are greedy and will do what they can to maximize profits. But, Congress continues to allow that greed. As long as it does, we will pay increasing amounts for our prescription drugs.

    It’s no surprise that Accountable.us, a government watchdog group reports that the big Pharma companies are prepared to raise prices significantly on more than 350 drugs. However many billions the pharmaceutical companies earned in 2022 is irrelevant if they can make more in 2023.

    For example, Pfizer is raising prices on more than 90 drugs.  Ibrance and Xalkori, cancer drugs, will see 7.9 percent price increases. Why would Pfizer want to put an end to soaring profits in 2021 and 2022 if it does not have to?

    Higher drug prices allow the pharmaceutical companies to say that they can invest more money for research. The truth is that these companies put more money into stock buybacks and dividends than on research. And, when they conduct research, the research generally focuses on drugs that are similar to what’s already on the market, where they know they can find huge demand, rather than drugs for rare conditions that have no treatments available.

    The Republican-controlled House of Representatives is unlikely to pick up where their predecessors left off on drug price negotiation, in the Inflation Reduction Act. Pharma gives oodles of money to them to make sure. So, for now, we have simply the possibility of Medicare negotiating drug prices for 60 drugs over the next several years–if Pharma does not succeed at blocking those negotiations.

    One reform, with some bi-partisan support, that Congress has a small chance of enacting, would allow Americans to import drugs from around the world from verified pharmacies. Ideally, the proposal would also require insurers to cover those drugs, as they would cost a lot less than the same drugs in the US.

    Today, millions of Americans import drugs from abroad for personal use, with no reported safety concerns, although it is not legal for them to do so. At the same time, tens of millions of other Americans can’t afford the drugs they need in the US, compromising their health.

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  • Sen. Bernie Sanders will focus on high health care costs as head of the HELP committee

    Sen. Bernie Sanders will focus on high health care costs as head of the HELP committee

    Next month, Senator Bernie Sanders will become chair of the Senate Health Education Labor and Pensions (HELP) committee. HealthcareDive reports that, in that role, among other things, Sanders will focus on high health care and prescription drug costs as well as elder care.

    In a recent video, Senator Sanders spoke of the huge profits in the pharmaceutical industry at the same time that Americans are going without critical drugs because they are unaffordable; many are dying. The Inflation Reduction Act is a first step towards reining in high drug costs for people with Medicare. It gives the government some power to negotiate drug prices for the 60 most expensive drugs over the next several years, beginning in 2026.

    But, Senator Sanders points out that the government’s prescription drug negotiating power is quite weak and explains that Congress has a lot more to do to rein in drug prices. As I see it, Congress should immediately open its borders to drug importation from verified pharmacies around the world and require insurers to cover imported drugs prescribed by treating physicians.  That is not a long-term solution to high drug prices, but it is a likely way to put downward pressure on drug prices quickly and help ensure that Americans can afford their medicines. Americans usually pay many times what residents of other wealthy countries pay for prescription medicines.

    The Inflation Reduction Act also caps annual out-of-pocket drug costs for people with Medicare at $2,000 beginning in 2025.

    Senator Sanders said the HELP committee would hold many hearings with health care and pharmaceutical company executives. Senator Wyden, as chair of the Finance Committee, has focused on the pharmaceutical industries’ failure to pay corporate taxes through international tax law shenanigans.

    Here’s more from Just Care:

  • Six tips for keeping your drug costs down if you have Medicare

    Six tips for keeping your drug costs down if you have Medicare

    Many people with Medicare find that they are paying a hefty amount for their drugs, even with prescription drug coverage. Drug companies have considerable power to set high prices for many drugs; insurers have little power to rein them in. Instead, insurers shift costs onto members who need high-cost drugs. That helps explain why government drug price negotiation remains a top policy issue in polls of likely voters. For now, there are ways to keep your drug costs down.

    Whether you are enrolled in a Medicare Part D prescription drug plan or a Medicare HMO or other private Medicare plan, copays or coinsurance for some drugs can be extremely high. Here are some options to save you money.

    1. Review the drugs you are taking with your doctor:  Your primary care doctor might be able to shorten the list of drugs you’re taking and, in the process, save you money. If you’re taking high-cost brand-name drugs, your primary care doctor might also be able to prescribe you lower-cost generic drugs. Generics must have the same active ingredients, same strength and purity and same effect.
    2. Ask your Part D drug plan or private Medicare plan about reducing your copay: If your drug is in the highest tier—requiring a very high copay–the plan might reduce the copay if your doctor can demonstrate that you have no other drug alternative for your condition that safely meets your needs.
    3. Extra Help: If you qualify for Extra Help, a program administered by Medicaid, it will pay for some or all of the cost of your drug coverage. The amount of help with cost-sharing depends on the level of your income and assets. In 2023, you may qualify if you have up to $20,385 in yearly income ($27,465 for a married couple) and up to $16,660 in assets  ($33,240 for a married couple). With Extra Help your drug costs are no more than $4.15 for each generic/$10.35 for each brand-name covered drug. You pay nothing after your total drug costs exceed $7,400. And, depending upon your income, you may pay only part of your Medicare drug plan premiums and deductibles. You get Extra Help automatically if you have Medicaid or a Medicare Savings Program. You can apply for Extra Help online here.
    4. Find out if you qualify for a State Pharmaceutical Assistance Program: In some states, state pharmaceutical assistance programs provide help with the cost of drugs. Visit Medicare.gov or contact your State Health Insurance Program to find out about drug benefits your state provides. You can also call 1-800-677-1116 or visit www.eldercare.gov.
    5. Drug company assistance programs: Some drug companies offer eligible individuals reduced prices for their drugs. Contact the Partnership for Prescription Assistance or NeedyMeds to find out if you qualify for help with your drug costs.
    6. Online pharmacies: You can often find significantly lower-priced drugs through online pharmacies. And, increasingly, people are using international online pharmacies to keep their costs down. Kaiser Health News reports that 19 million people in the U.S.–eight percent of Americans–now buy their drugs outside the US to afford them. But, you must be careful you are using a legitimate pharmacy and not an outfit selling counterfeit or expired drugs. Also, it is technically illegal to import drugs from abroad, although it appears that no one has been prosecuted for doing so for personal use. Here’s what to consider.

    Keep in mind: If you are a Vet, you likely can get low-cost drugs through the Veterans’ Administration.

    N.B. This post was originally published on November 18, 2019 and has been updated.

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  • Germans force competition among drug companies; should the US follow suit?

    Germans force competition among drug companies; should the US follow suit?

    In an article for Health Affairs, James C. Robinson argues that the US should take a page from Germany to drive competition among pharmaceutical companies and to lower drug costs for individuals. Medicare and other insurers should pay a fixed fee for drugs with the same clinical benefits, regardless of their cost, and leave it to individuals to decide which drug to get. Ideally, drug manufacturers with costlier drugs would be forced to bring down their prices in order to compete effectively.

    It seems insane that drug manufacturers can charge very different prices for drugs that are similar in effect, and that Medicare and other insurers will pay more for drugs that are no more efficacious than less expensive drugs.

    In Germany, when there are three or more drugs that are equally effective, they are treated as if they are in the same therapeutic class. They might be brand name or generic or both. The insurer then pays no more than a particular price for all these drugs, which the insurers collectively set.

    Patients have a powerful financial incentive to choose the lowest-priced drugs when they offer similar clinical benefits as the higher-priced drugs. Patients must pay whatever the difference in cost for the higher-priced drugs. Generally, this leads the manufacturers of the higher-priced drugs to reduce their prices.

    Insurers in Germany are generally able to negotiate additional discounts on a single drug in that class through a confidential rebate system with the manufacturer of that drug. The manufacturer wins with more business; consumers win with lower prices.

    For the German reference pricing system to work best, there need to be several drugs in a class. So, the German government broadened therapeutic classes for biologics and biosimilars, where there are otherwise too few drugs to promote competition.

    The system in the US does not begin to work as well for several reasons. The authors focus on the fact that all drugs in a therapeutic class tend to cost consumers around the same coinsurance amount, so pharmaceutical companies don’t benefit from bringing down their prices. Moreover, the coinsurance amount can be so high that patients are forced to skip filling their prescriptions.

    The US drug pricing system is inequitable, discriminating against people with lower incomes. People pay too much for drugs that are fairly priced and not enough for drugs that are overpriced.

    Why shouldn’t drugs be priced in keeping with their value so that manufacturers set fairer prices and patient’s can more easily afford them. Higher out-of-pocket costs should accompany drugs that are priced above their clinical value. Drugs should be easily affordable to people when they are priced at their clinical value.

    Insurers in the US have not used reference pricing for drugs for two principal reasons. Pharmacy Benefit Managers, the middlemen who buy drugs from pharmaceutical companies and design and administer insurer formularies don’t like it. Reference pricing would eat into the enormous profits they make from rebates they get from manufacturers to list their high-priced drugs on a formulary at a low out-of-pocket cost. And purchasers worry that they take a risk with reference pricing that they don’t want to take.

    But, insurers should test reference pricing on biologics and biosimilars with the same clinical value. Patients would then pay less for lower-priced drugs and more for high-priced drugs that are not superior. The result could yield significant savings and help ensure people can afford their drugs.

    Here’s more from Just Care:

  • 2023: Medicare Part D prescription drug coverage and costs

    2023: Medicare Part D prescription drug coverage and costs

    Whether you are enrolled in traditional Medicare or a Medicare Advantage plan, Medicare covers the prescription drugs you get from the pharmacy under Medicare Part D. The vast majority of people with Medicare, 49 million in 2022, are enrolled in a Part D drug plan. Here’s what you need to know about Medicare Part D coverage and costs in 2023.

    Don’t assume that your current Part D drug plan will cover your drugs in 2023, even if they did in 2022. Rather, assume that your costs will go up a lot if you didn’t check which Part D plan was likely to save you the most money based on your drug needs, during the Medicare open enrollment period (October 15-December 7). Each year, these private insurance plans can change dramatically. Kaiser Family Foundation reports on your options.

    As a general rule, close to three in four people enrolled in traditional Medicare and a Part D plan will pay higher costs the following year, if they do not look at their options and switch plans.

    In 2023, there are 16 national Part D prescription drug plans, with monthly premiums ranging from $6 to $111. The average premium is $43, up 10 percent from 2022. AARP offers the highest cost Part D drug plan.

    Premiums: Premiums are typically higher for Part D plans offering enhanced benefits, lower cost-sharing and/or low or no deductibles. Standard Part D plans have an average monthly premium of $37. Part D “enhanced” plans that charge no or a low deductible have an average monthly premium of $48 in 2023.

    Standard deductible: The standard and highest possible deductible—the amount you must pay before your coverage begins—is $505.

    If you have traditional Medicare: You typically will be able to choose among 24 Part D drug plans. Depending upon the state you live in, your options range between 19 and 28.

    If you are in a Medicare Advantage plan: You typically will have a choice  of around 35 Part D drug plans.

    Cost-sharing: For non-preferred brand name drugs, coinsurance could be as high as 40-50 percent and as low as $0 for preferred generics, depending upon the Part D plan you choose. You also are likely to pay 15-25 percent coinsurance for preferred brand drugs.

    Typically you’ll pay about $1 for preferred generics and $5 for generics. You’ll pay around $44 copay for preferred brands, 45 percent coinsurance for non-preferred drugs, and 25 percent coinsurance for specialty drugs.

    Costs in each coverage phase: After you have paid your deductible, you are in the initial coverage phase, where you generally will pay around 25 percent of the cost of both brand-name and generic drugs until your drug costs total $4,660. You will then be in the coverage gap phase, where you will be responsible for about 25 percent of the cost of your drugs. Once your out-of-pocket drug costs total  $7,400 in the coverage gap phase, you will be in the catastrophic coverage phase . At that point, you will pay no more than 5 percent of the cost of your drugs or $4.15 for each generic and $10.35 for each brand-name drug.

    If you qualify for a low-income subsidy (LIS) or Extra Help: You will have lower out-of-pocket costs, depending upon the Part D plan you choose and the drugs you use. Around 13 million people with Medicare qualify for extra help with their prescription drug costs. There are 198 Part D drug plans for which you will not pay a premium. You can also choose a “non-benchmark” plan and pay a portion of the monthly premium.

    If you need insulin: The Inflation Reduction Act limits your monthly copayment to no more than $35 in all phases of Part D coverage. However, that limit applies only to insulin in a plan’s formulary, not all insulin products.

    If you need a vaccine: Vaccine costs are covered in full for vaccines that are on the Part D formulary.

    Here’s more from Just Care:

  • The high costs of Medicare Advantage and how to address them

    The high costs of Medicare Advantage and how to address them

    Taxpayers and people with Medicare are overpaying big time for Medicare Advantage, the corporate health plans that offer Medicare benefits. In a letter to the New York Times, Richard Kronick, a former government official, explains that the administration has the power to address Medicare Advantage’s high costs and reduce the heavy financial load Medicare is bearing. The Centers of Medicare and Medicaid Services (“CMS”) needs to adjust the way it pays Medicare Advantage plans.

    Right now, CMS pays MA plans a flat fee per enrollee and that fee is adjusted up, based on the diagnosis codes of each enrollee, thereby incentivizing the Medicare Advantage (MA) plans to identify as many diagnosis codes as possible for each enrollee.

    Kronick estimates that, if CMS does not fix its method for calculating payments to Medicare Advantage plans, overpayments to Medicare Advantage will be more than $600 billion in the next nine years. Some Medicare Advantage plans are engaging in fraud and inappropriately adding diagnosis codes to patient records. But, stopping their behavior, were it possible, won’t fix the overpayments. Because of the way the government pays them, all Medicare Advantage plans are adding as many appropriate diagnosis codes to patient records as possible–so that they will be paid more–even when for patients who might not need or receive any additional services.

    Kronick suggests that CMS payments to Medicare Advantage could be adjusted to be more in line with Traditional Medicare, instead of about four percent more. His fix would correct one piece of the problem with payments to Medicare Advantage plans. But, the big problem lies with the government paying Medicare Advantage plans a fixed amount per enrollee unrelated to the cost of covering their health care services. So long as Medicare Advantage plans profit more when they deny or withhold care, they are likely to deny or withhold care or send enrollees to low cost providers as much as they can.

    If the government wants to ensure Medicare Advantage plans well-serve the needs of people with costly conditions, it must pay them based on the cost of services they cover. On top of that, Medicare Advantage plans should receive a care management fee. To contain costs, the total payment amount should be capped.

    Here’s what you need to think about when it comes to costs in Medicare Advantage:

    Medicare Advantage (MA) often costs less than Traditional Medicare and supplemental coverage for people who use relatively few health care services. But, people in MA plans cannot buy supplemental coverage to pick up deductibles, copays and other out-of-pocket costs. These out-of-pocket costs can total as much as $7,550 a year for in-network care alone.

    Medicare Advantage costs more than Traditional Medicare for:

    • Taxpayers: The government has always paid more for MA than Traditional Medicare. MA is projected to cost $600 billion more over the next nine years.
    • Everyone with Medicare: People in Traditional Medicare as well as in MA pay higher Medicare Part B premiums because of MA’s higher costs.
    • People with complex care needs: People in MA often face financial barriers, including copays and deductibles, which can force them to forgo critical care. Out-of-pocket costs in Medicare Advantage could be as high as $7,550 a year, a lot more than Traditional Medicare with supplemental coverage. In Traditional Medicare, people with supplemental insurance have few if any out-of-pocket costs. Supplemental insurance typically costs around $2,500 a year.

    Medicare Advantage causes stress and anxiety for people with complex care needs that they do not face in traditional Medicare. They disenroll from MA at disproportionately high rates.

    Medicare Advantage offers less value than Traditional Medicare. The available data suggests that people in MA, overall, receive about the same quality care as people in Traditional Medicare. But, the cost of MA is significantly higher. Higher costs and similar quality mean lower value in MA. 

    Fixed payments to Medicare Advantage wastes taxpayer dollars. MA receives around $12,000 a year on average per enrollee, including the 50 percent of enrollees with few health care needs who cost Traditional Medicare an average of $875 a year, wasting taxpayer dollars.

    Medicare Advantage imposes additional untold costs. Many insurers offering MA have long histories of engaging in fraud against the government. Because they operate largely in secret, much of their behavior goes undetected, at unknown cost to people’s health and well-being.

    Medicare Advantage plans have never released reliable cost data. In a recent report, their consultants state that estimates of MA costs are  “inherently uncertain.”

    Here’s more from Just Care: