Expanding Medicare Advantage to
Rural Minnesota:
Challenges and Opportunities
Nancy Feldman, CEO, UCare Minnesota
Minnesota Rural Health Conference 2005
Duluth, Minnesota
July 19, 2005
UCare Minnesota
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One of Minnesota’s leading HMOs.
Over 20 years experience improving
and maintaining the health of
Minnesotans.
Minnesota-based.
Provides coverage and services for
130,000+ Minnesotans.
UCare, Rural Minnesota and
Medicare
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Operating in rural Minnesota since
1996.
In Medicare managed care since 1998.
As of 7/1/05, UCare offering Medicare
Advantage in 64 counties.
As of 1/1/06 UCare expanding
Minnesota Senior Health Options.
Licensed Service Area
July 2005 - 77 Counties
9
Health challenges in rural areas
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General rural challenges include:
 Higher prevalence of chronic disease
– related to aging of population.
 Lower incomes.
 More risky behaviors like smoking.
 Clinical and social supports may be
less accessible.
Medicare managed care and
rural Minnesota
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Rural Medicare managed care has a
mixed history.
Medicare Plus Choice did not work for
rural Minnesota.
2003 Medicare Modernization Act made
it feasible and affordable.
Creating great Medicare products for
rural seniors is a UCare priority.
Medicare Advantage:
Opportunities
Opportunities for consumers
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More comprehensive, more affordable
coverage and care = better value.
Emphasis on prevention and wellness.
For those with chronic illness, the
program offers care coordination and
disease management.
Less paperwork.
Opportunities for Consumers:
Value Equation
“Medicare Advantage managed care plans represent
a better value for most Medicare beneficiaries than
Medigap supplemental insurance…Most Medicare
beneficiaries can expect a 50% savings or more in
their annual out-of-pocket costs…”
--HealthMetrix Research Inc.
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Visit www.hmos4seniors.com for cost/value
comparisons
Opportunities for Consumers:
Value Equation
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Incentives for healthy behavior
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Mammography outreach
Healthy lifestyle and fitness
Programming targeted at chronic
disease
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Talking scales
Falls prevention
Opportunities for providers
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Access to quality improvement
programs and incentives.
Coordination with case management
and disease management programs.
Support for training.
Working (in UCare’s case) with a small,
rural-friendly organization.
Medicare Advantage:
Financial Challenges
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Payment mechanism for Critical Access
Hospitals: prospective vs. cost-based.
UCare is working closely with CAHs to
develop payment mechanism that
works for them.
UCare is committed to making the
financial end of Medicare Advantage
work, for consumers and providers.
Medicare Advantage:
Challenges for Consumers
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New Medicare Advantage options +
Medicare prescription drug options +
information overload = consumer
confusion.
Simplify process
UCare offering community information
sessions on Medicare reform (to date over
4,000 individuals reached).
Easy as possible
Medicare Advantage is
a plus for rural seniors.
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Local plans like UCare recognize that health
care is local.
Metro-only products with high value now
available to rural eligibles.
Medicare Advantage is about keeping
seniors healthy. Rural seniors deserve it!
Medicare Advantage is here to stay.