'I Am As Confused As Can Be': Aaron Bean Slams High Cost For Medicare Programs

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During a House Ways and Means Committee hearing before the Congressional recess, Rep. Aaron Bean (R-FL) asked CEO of Alignment Health Plan and President of Alignment Health Dawn Maroney about whether or not Medicare is a cost-efficient program.

Transcript

00:00I now recognize Mr. Bean. Thank you very much, Mr. Chairman. Good afternoon to you and good

00:05afternoon Ways and Means Committee and to our panelists. Welcome. We're glad to have you here.

00:10I, like Dr. Murphy from North Carolina, am a big fan of managed care. I was a state legislator

00:15for many years in the free state of Florida. We partnered with managed care to get our spending

00:21under control, and I think Florida has one of the largest state surpluses in the nation. It's

00:26because we finally worked to make that happen, but I'm going to be honest with you guys.

00:32I am as confused as can be. I was hoping to learn what's the, what is the deal with managed care?

00:40Because you heard that, we've heard that the quality is high, but yet costs are, we don't know.

00:46Is it, is it better than fee for service cost-wise or, or not? What if, what if there was a bill?

00:53What if there was a bill that required CMS, hear me out, CMS to release the full data of,

01:00of managed care versus fee for service so we could see once and for all where the savings

01:08are and what's happening. I got good news ways it means I have filed that bill. I call

01:14it the apples to apples bill. Let's let CMS release the full data so we can make a full decision

01:21of where we need to go. I think, uh, health care is kicking our financial fanny as a country and

01:27until we get those costs under control, then, uh, then we're going to struggle with debt. So first

01:34question, here we go. Mrs. Maroney, uh, some say, uh, we're saving money. Some say we're not saving

01:40money on, uh, on managed care. We know there's benefits. So can you tell me, is Medicaid Advantage

01:47delivering a cost-efficient solution for seniors and taxpayers?

01:52Absolutely. Uh, when you look at the average consumer that, or beneficiary that enrolls into

01:57an MA plan, they're over, older than 71 years old. The average premium is about $17 for those, um,

02:04individuals. Um, however, for our program, most of those individuals have a zero premium plan.

02:10They have full comprehension when it comes to the Part C and the Part D benefits.

02:13How do you know? Do we have full data? You feel really comfortable if I was a scale,

02:17if I were to ask you on a scale from one to 10, how confident are you on that answer?

02:21What would it be? Uh, probably about nine and a half.

02:24Okay. So you say there's room for improvement of that answer. So, uh, let's go to Dr. Miller,

02:29because you've talked about this in your testimony that, uh, that, uh, we're not comparing you.

02:34In fact, you've said it's apples to oranges, some of the data that we're getting from, uh, from CMS.

02:39Uh, wouldn't this be a good bill? And if you were in Congress, would you vote for the bean bill,

02:44apples to apples? I mean, I, I'd have to read the details, but I agree with the principles.

02:49I think right now we're doing, uh, apples to kumquat trees. So I take it a step further.

02:55The problem is, is that we're only looking at the beneficiaries who switch from fee-for-service to

02:59Medicare Advantage. We're not looking at beneficiaries who switch from Medicare Advantage to fee-for-service.

03:04And we're certainly not looking at the choice that millions of Americans make when they enroll in

03:09Medicare and comparing those bennies who are in fee-for-service and Medicare Advantage. So

03:14that 22% number, I actually think that it's not accurate because it only represents a small share

03:20of the Medicare population. And there was no control group.

03:2410-4-0. Thank you so much. Dr. Basil, uh, welcome to the party. Jump in. What say you to have an,

03:30I know docs like to have more information than less information. So what say you?

03:36So as far as in my comments, you know, one of the things we asked for was greater transparency. And

03:40so transparency is absolutely something that we support. Now you asked about, you know,

03:46how do you compare the quality before? And I can say that, you know, within our own shop,

03:50in many ways, some of our Medicare Advantage patients actually have higher level of qualities.

03:54You know, the percentage of our Medicare Advantage patients that get annual wellness visits is

03:58actually much higher in our MA plans than it is in our traditional Medicare plans. And many other

04:03quality metrics are that way. But we don't have that full realm of quality outcomes to be able

04:09to compare apples to apples. I would agree. 10-4. You know, in the state of Florida,

04:12what we do is we capitate the plans. We pay them. We already knew what fee-for-service was. We came in

04:19much under that and allowed managed care to go forward. Is there, uh, is there fraud and savings to be

04:25found? I'm, uh, working with this Doge, uh, the Doge conference, so to speak, to work on, uh, savings.

04:34Is this a good place to look, uh, Dr. Miller? I'd say there are a couple of bad actors that

04:40definitely probably deserve a visit with the Department of Justice. But on the whole,

04:45the program, I would say from a fraud, waste and abuse perspective is not the major target.

04:5010-4. 60 out of the 550 MA plans were audited last year. Uh, President Trump says we need to audit

04:57all of them. With that, I yield back. Thank you, Mr. Chairman.

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