CMS and Seema

CMS and Seema



Hey everyone and welcome back!

I want to talk to you about something that is going on now that is so impressive: we have a government-pending shutdown.

Is it going to shut down? Is it not?

Is it going to stay open? We don’t know.

But that’s why it’s so impressive when you have a bipartisan backing on something going to The White House.

Everybody agrees to this. Yes, everybody is agreeing to the concepts that were put forth by CMS in December of this past year by Seema Verma.

The suggestion was to expand Medicare Advantage plans and push forward for value-based insurance design as much as possible.

Value-based insurance design, as we’ve discussed in the past, is something that’ll keep the cost down for the membership and the insurer by making sure that the value is at the highest level possible for the care that is provided.

So, I just want to point out to you all, that we will see a big expansion from the insurance companies on Medicare Advantage and of course, more membership on Medicare Advantage plans.

You probably already knew this because you saw our preview 2019 video where we discussed this would be coming down the pipe.

So, yes, this is something that was suggested by Seema Verma and, by the way, Seema, what does a guy have to do to get connected with somebody on LinkedIn?

I put the request out there, I keep trying to get connected. Seema, do you see me?

Another thing that I want to point out, back to business, is Any Willing Provider.

This is something that is in certain areas of the marketplace where, if you’re a willing provider and you want to participate with a certain health plan you are able to.

They are also suggesting that this gets scaled back because it is putting the insurers a little bit in a corner.

By making them have to bring providers in network, that takes away their leverage. Therefore, in order to keep their cost down, they end up charging the membership more money, which nobody likes.

So, they did put in a suggestion regarding the Any Willing Provider to try to scale that back down. But, remember, for the Medicare Advantage plans, yes, you probably will see a big expansion of that.

So, while the government is deciding if they should shut down or not, you just make sure that your business doesn’t shut down. That’s what you’ve got to do and they’ll handle that part.

If you have any questions, comments, or suggestions, please let us know so that we can make this better for you.

Happy New Year from LTC Consulting Services!

Happy New Year from LTC Consulting Services!




2018 was a whirlwind of a year.

There was so much going on and we helped so many clients this year that the memories are just amazing.

We’ve had clients that have been just spinning their wheels without making any headway at all.

And then there were some who found themselves stuck in a hole and they needed our help to get pulled out.

Would you try winging it on your own? Or attempt getting away cheap?

This year, don’t settle for mediocrity. Rather, trust the pros at LTC.

The New Medicare Advantage – Coming 2019 to an Insurance Broker Near You

The New Medicare Advantage – Coming 2019 to an Insurance Broker Near You




In a world of well intended plans, there is one plan that stands out. It’s called Medicare Advantage, with one company pushing the limits even further.

Imagine getting paid to walk. Well, there’s an insurance company paying out millions of dollars a year to people who meet walking goals.

Where skill used to be everything, or should I say skilled care, but now CMS raises the stakes.

The folks at Medicare got together and they’re scratching their heads and they’re like, “This doesn’t seem right. If our coverage is for primarily health-related care, we should be covering more nutritious food, transportation to health-related services, independent living, assisted living, adult daycare…Other health care settings are now considered for Medicare reimbursement.

A place where wellness programs fail. A new data rich Medicare Advantage is getting stronger by the day, enforcing individual healthy habits.

Get ready for more insurer-promoted healthy choices, like free gym membership for people that clearly do not need it.

Of course the most annoying are those people in exceptionally good shape at the gym. I’m always like, “What are you doing here? You’re done. What are you, rubbing it in? Luckily there’s always one or two people at the gym you look at and you’re like, “Don’t bother. You’re wasting your time. And then you realize it’s just your reflection in the mirror.”

The new Medicare Advantage coming in 2019 to an insurance broker near you.