From Dennis Leone, August 13, 2007
Subject: Medicare Advantage Plan IS on the Agenda
Shirlee, John, and Nancy – I have received my packet for the Board’s August 16-17 meeting, In response to your question, the answer is yes…….staff is recommending that the STRS Board approve “adding AultCare’s Medicare Advantage HMO to the STRS Ohio Health Care Program.” A vote on this matter is scheduled to occur sometime after 9:00 a.m. on Thursday, August 16, likely after 11:00 a.m., but before noon. The recommendation is on page 56 of the board packet. There are 4 pages in the board packet (page 52-55) that provide the staff’s justification for the recommendation and the premiums associated with it. The following is on page 53:
“The AultCare HMO offers significant premiums savings to enrollees. AultCare’s ability to provide less expensive premiums result from the provider discounting and the plan’s care management. This health plan is controlled by the Aultman Health Foundation and has a regional focus. The AultCare Medicare Advantage HMO option is now available in five counties: Wayne, Stark, Carroll, Holmes, Tuscarawas. AultCare has offered a Medicare managed care plan for 10 years and has more than 18,000 enrollees.”
The staff’s “conclusion” is shown on page 54, as follows:
“Staff does not recommend adoption of the Aetna or Medical Mutual PFSS plans for 2008 for the reasons previously described (………. “plans are more limited in their ability to manage care and in their ability to control medical costs”). Staff recommends the adoption of AultCare’s Medicare Advantage HMO for the following reasons:
• Plan offers favorable premiums.
• Plan has stability and should be a low cost option for several years.
• AultCare has the experience of offering a Medicare managed care plan for 10 years and has more than 18,000 covered lives in the market place.
• Pilot program will help staff learn more about this type of plan offering.
• Adverse selection, if any, caused by this plan offering is expected to be limited.”
I intend to vote no absent speaking first with retirees with Wayne, Stark, Carroll, Holmes and Tuscarawas counties. I would appreciate hearing from retirees from those counties by Wednesday night, before 10:00 p.m. if possible, about their experiences with the Advantage program.