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In preparation for 2014, Medicare Advantage plans have 'soft opening'

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The Centers for Medicare and Medicaid Services released January 2013 enrollment numbers for Medicare Advantage plans – commercially-operated plans seniors can select over the federal program.
In New Jersey, two provider-based Medicare Advantage plans made their entry into the market.

The provider-based Medicare Advantage plans are crafted around networks of “preferred” care providers in an effort to keep costs down and improve integration of care between providers.

Bayonne Medical Center, Christ Hospital and Hoboken University Medical Center are offering the CarePoint Advantage plan through their parent company’s insurance group, CarePoint Health Plans. For January 2013, enrollment in the CarePoint Advantage plan was 142 for Hudson County, the only New Jersey county where it is being offered.

Tom Considine, former commissioner of the Department of Banking and Insurance and chief operating officer of MagnaCare, which operates the back end of the CarePoint Advantage Plan, said the 2013 enrollment numbers make sense as the group wanted to “get it right” before wider enrollment in 2014.

“Globally, the numbers are all over the place,” Considine said. “The plans came to it with different things in mind. Some plans wanted to get a head start and try and say ‘Hey, look at me, I ran up some big numbers here, so I’m a market leader.’ I think other plans wanted to have what’s known in the restaurant business as a ‘soft opening’ in order to get it done right, knowing full well that the real open enrollment period is October of this year for the Jan. 1, 2014 date.”

“They have different strategies, but ultimately the same goal – to be the most effective plan come Jan. 1, 2014,” he added.

In 2012, Meridian Health announced it would offer a Medicare Advantage plan through Pennsylvania-based Geisinger Health. Geisinger Gold, as the plan is called, was offered to seniors in Monmouth and Ocean counties, and 618 people enrolled in the various versions of the program for 2013.

John Lloyd, CEO of Meridian, had said when the plan launched he hoped to enroll 3,000 to 5,000 seniors in the plan during its first year of existence.

Meridian did not provide comment before publication.

Geisinger Health Medicare Advantage customers can select from a preferred provider organization (PPO), health maintenance organization (HMO) or medical savings account (MSA). CarePoint offers a PPO or a special needs plan (SNP) to its customers.

The January numbers also included enrollment in Program of All-inclusive Care for the Elderly (PACE), which combines Medicare and Medicaid payments to help patients who need nursing care stay independent. Four PACE plans had enrollees in New Jersey for 2013; 155 with Life at Lourdes in Camden County, 187 through Life-St. Francis in Mercer County, 120 with Lutheran Senior Healthcare Inc. in Hudson County and 62 with SJH Life, Inc. in Cumberland County.

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