The Villages Health - Grandfathered?!
 

Grandfathered? Think again. If you have Medicare Original get ready to be "porked". Beginning January 1, 2017 you either switch to United Healthcare Medicare Advantage Plan or seek care elsewhere. They will tell you that it is to improve the quality of care, but it has only to do with increasing the quantity of money! They are sucking a lot of red ink due to the quality of their top management staff.

That and the fact that their physicians have a very low case load which was the initial promise of the model.


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Where did you get your information?

The Villages Health - Grandfathered?!
 

I have been following their system since before doc recruiting began. If you research the initial PR, you'll find that the system was built upon the premise of significantly decreasing a physician's caseload when compared to avg caseloads of physicians in "normal" practices.

Here is one article. There are others that include more specific information, but you should get the point from this 2012 article.

http://villages.health.usf.edu/articles/release1.pdf

I should also note I know about the individual who was recruited to form the practices.



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Yes, where did you hear this? What is your source? I have contacted SHINE to see if they have any info on this.

".....Impossible Burden For The Elderly And The Disabled

About half the cost of the ACA (Affordable Care Act) is paid for by cuts in Medicare spending and the only practical way those cuts can be made is by reduced fees to providers.

The Medicare actuaries have noted with alarm that Medicare fees to doctors will drop below Medicaid levels in the near future and the combined effect of lower Medicare and Medicaid hospital spending will drive one in seven hospitals from the market in the next five years.

Although the administration talks about making Medicare more efficient, three separate reports by the Congressional Budget Office (CBO) have concluded that the pilot programs and demonstration projects that are supposed to find these efficiencies are not working.

In fact, the only place in Medicare that shows any promise at all is in the Medicare Advantage (MA) program. But the administration is determined to proceed with cuts in MA subsides and appears to be paying no attention whatever to the efficiencies MA entrepreneurs are discovering.

Because no serious budget analyst believes the Medicare spending cuts can withstand the inevitable political backlash and because they don’t believe the pilot programs will work either, both the CBO and the Medicare Trustees are annually publishing “alternative forecasts” in an effort to predict how Congress will cave. But if Congress does cave and restores the previous Medicare spending path, that means that the ACA isn’t paid for; and that, in turn, means large unfunded liabilities stretching out indefinitely into the future and increasing federal debt......"

Six Problems With The ACA That Aren’t Going Away

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How could The Villages do this to us all? I was told as many as 10,000 will be dumped unless we cancel traditional Medicare and go with the United Advantage plan. We that were grandfathered in a while back will be out. You can say it is a rumor, but some are taking the initiative and seeking a new physician before so many are cut loose.
We were at that first meeting when the physical of bellview explained the program. We signed up immediately. We are disappointed.

This will be a new paradigm for the foreseeable future.

When you look in a dictionary, your post will show up as the definition of "bait and switch"

7-15-2015

"Marilyn Tavenner is about to make an unprecedented move: From head of Medicare, to the nation’s top lobbyist for private insurers — in just six months.

Tavenner will succeed Karen Ignagni as the CEO of America’s Heath Insurance Plans, the New York Times reported on Wednesday. Tavenner had served as the administrator of CMS for more than three years, where she was responsible for Medicare, Medicaid, and much of Obamacare’s implementation.....

...“Asked about her priorities, Mr. Tavenner said she wanted to protect Medicare Advantage, the program under which private insurers manage care for more than 30 percent of the 55 million beneficiaries of Medicare.”

There’s a reason why private insurers care so much about Medicare Advantage: It’s arguably their hottest market right now.....

...The resurgence of Medicare Advantage is a stunning turnabout for a program that was supposed to be dead in the water, thanks to the Affordable Care Act....."

Full story:
Forbes Welcome

http://www.nytimes.com/2015/07/16/us...-lobbyist.html

What information have you received from SHINE? Those of you on TOTV who do not want to go with United Advantage or cannot due to pension benefits restrictions, what is your plan?

Best of 2015 AcademyHealth Annual Research Meeting

Higher Incentive Payments in Medicare Advantage's Pay-for-Performance Program Did Not Improve Quality But Did Increase Plan Offerings

Authors
Timothy J. Layton Ph.D.,
Andrew M. Ryan Ph.D.
First published: 9 November 2015

Objective
To evaluate the effects of the size of financial bonuses on quality of care and the number of plan offerings in the Medicare Advantage Quality Bonus Payment Demonstration.

Data Sources
Publicly available data from CMS from 2009 to 2014 on Medicare Advantage plan quality ratings, the counties in the service area of each plan, and the benchmarks used to construct plan payments.

Study Design
The Medicare Advantage Quality Bonus Payment Demonstration began in 2012. Under the Demonstration, all Medicare Advantage plans were eligible to receive bonus payments based on plan-level quality scores (star ratings). In some counties, plans were eligible to receive bonus payments that were twice as large as in other counties.....

Conclusions
At great expense to Medicare, double bonuses in the Medicare Advantage Quality Bonus Payment Demonstration were not associated with improved quality but were associated with more plan offerings.

Health Services Research Higher Incentive Payments in Medicare Advantage's Pay-for-Performance Program Did Not Improve Quality But Did Increase Plan Offerings - Layton - 2015 - Health Services Research - Wiley Online Library

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I, too, feel I was welcomed into the system in the hopes of getting me to go with United Health Care. They certainly have a right to make that decision but if that was their plan all along I wish they would have been honest about it to spare me the trouble of switching everything again.

Am I missing something or am I confused? Is this for people under the age of 65?

I was under the impression that I could switch to Original Medicare with a supplement when I needed to. Doesn't TV Health Care take original medicare?

If it doesn't, then I will have to find a doctor that does take original Medicare, outside of TV Health Care system.

right now it's people who are turning 65. they are told they have to switch to the advantage plan. those that do not choose to do so have to find someone else. now, my neighbors who were 65 when they joined when it started are still supposedly grandfathered in. however, I believe the op was saying as of 2017, they will be required to make the same choice. would be best to call and ask them.