Freedom Health, a Florida based Medicare and Medicaid insurer, has seen dramatic success in recent years. However, the future is anything but certain in the wake of health care reform's passage and pending changes to the Medicare Advantage program.
The Tampa, FL. Based insurer has enjoyed remarkable success and accolades since its founding in 2004. Among these are:
For the fourth consecutive year Freedom Health was awarded the Senior Choice Gold Award for Excellence in Medicare Benefits Value awardee from Medicare News Watch (2007-2010).
7th fastest growing U.S. company:
Freedom Health is the 7th fastest growing U.S. company (1st place health insurer) with 10,035% revenue growth - Inc. Magazine (2009 Inc. Magazine Top 500).
- Ranked #1 best benefit value the last 4 years running by the National Committee for Quality Assurance
- 2009 revenue of nearly $183 million in 2009,
- 231 employees has seen astounding growth since its founding in 2004.
- 2010 the insurer offers 20+ plan options under the Medicare Advantage federal healthcare program umbrella.
Coverage and Plans Offered:
Freedom Health has benefited from the Medicare Advantage program which replaces traditional Medicare in a managed care HMO format with no need for a supplement. In short, its all-in-one comprehensive coverage that is both convenient and inexpensive. The inexpensive premiums are due to subsidies the federal Centers for Medicare and Medicaid Services (CMS) provides Medicare Advantage contracted plans as an incentive to participate and therefore reduces traditional its own Medicare fee-for-service operational costs.
What Changes will Federal Health Care Reform Bring?
Within the federal health care reform bill, the Patient Protection and Affordable Care Act, Medicare Advantage plans undergo a major payment restructuring. CMS plans to phase-in revised payments over 3 years beginning in 2011, for plans in most areas, while others will have payments phased-in over longer periods of four or six years.
Payment rates to Medicare Advantage plans will be frozen at 2010 rates. In 2012 CMS will begin to provide bonuses to plans receiving 4 or more stars, based on the current 5-star quality rating system for Medicare Advantage plans. Those quality bonuses will be worth up to 10 percent in some markets.
In 2014 Plans will be required to have a minimum loss ratio of 85 percent. If the loss ratio falls below 85% the plan will be required to return the difference to CMS. The payment restructuring is necessitated by the assertion that Medicare Advantage plans have received overpayments estimated at between 12-14 percent, according to Nancy-Ann DeParle, Director of the White House Office of Health Reform.
Given these drastic changes in payments to Medicare Advantage plans there is much trepidation in this market segment as 2011 approaches. Providence Health Plan CEO Jack Friedman sums up that trepidation when he asserts, “everyone (in the industry) will share in the pain."
According to Dwane McFerrin with the Agent Sales Journal, “The carriers with low administrative costs and high quality will win.” It appears that Freedom Health, based on its track record of quality and value thus far, is poised to accomplish just that.
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