Expanding Medicare Advantage to Rural Minnesota:

Challenges and Opportunities

Nancy Feldman, CEO, UCare MinnesotaMinnesota Rural Health Conference 2005Duluth, MinnesotaJuly 19, 2005

UCare Minnesota

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

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 AreaJuly 2005 - 77 Counties

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Health challenges in rural areas

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 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

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.

Visit www.hmos4seniors.com for cost/value comparisons

Opportunities for Consumers: Value Equation Incentives for healthy behavior

Mammography outreach Healthy lifestyle and fitness

Programming targeted at chronic disease Talking scales Falls prevention

Opportunities for providers

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 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 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.

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.