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This is 65Author: Erin Ackenheil
This is 65 features inspiring stories from accomplished professionals, ages 65 and beyond. Host, Erin Ackenheil, owner of Black Point Insurance, is a health insurance agent that loves to interview amazing people that she meets through her work. These impressive business owners and career-focused individuals have reached a time in their life where they can reflect and share with the world how they found success along the way. Get ready to be inspired and motivated by the fascinating stories of This is 65. Language: en Genres: Business, Education, Marketing, Self-Improvement Contact email: Get it Feed URL: Get it iTunes ID: Get it |
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Medicare, Costs, and Care Management: What Retirees Need to Know
Episode 49
Tuesday, 3 March, 2026
Healthcare journalist and speaker Mark Hagland joins the show to explain how Medicare Advantage fits into the broader U.S. healthcare system. With more than three decades covering health policy, payment models, and hospital operations, Mark breaks down rising healthcare costs, the shift to value‑based care, and why more than half of Medicare beneficiaries are now in Medicare Advantage plans. He discusses the role of federal regulators, the growth of care management and special needs plans, and what consumers should evaluate when choosing between Original Medicare and Medicare Advantage. The episode closes with practical guidance on research, plan selection, and a message of cautious optimism for patients navigating complex systems. Follow Mark on LinkedIn here. Follow Erin's company, Black Point Insurance, on Instagram here. Follow Erin on Facebook here. Five key takeaways 1. U.S. healthcare spending is projected to rise from roughly 5.6 trillion dollars a year to about 8.5 trillion by 2033, reaching around 20 percent of GDP. 2. An aging population and a high burden of chronic disease, including many people living with four or more chronic conditions, are major drivers of cost growth. 3. Medicare Advantage now covers about 54 percent of Medicare beneficiaries, including millions enrolled in special needs plans focused on complex conditions. 4. Value‑based care and care management programs aim to keep patients healthier and avert avoidable hospitalizations, especially for those with multiple chronic conditions. 5. Federal agencies are steering policy away from traditional fee‑for‑service Medicare toward models that reward quality, outcomes, and population health management. Timestamped overview 00:00 – Introduction to Mark, his career in healthcare journalism, and why Medicare and Medicare Advantage interest him as both observer and beneficiary. 06:00 – Why healthcare fascinates him: policy complexity, quality measurement, and real‑world impact on patients. 12:00 – National cost trends, aging demographics, and the burden of chronic disease in the U.S. 18:00 – Early disease‑management clinics and how modern care management builds on those ideas at scale. 25:00 – How value‑based care and pay‑for‑performance contracts try to align payment with health outcomes. 31:00 – Medicare Advantage basics, growth from 19 percent to 54 percent of beneficiaries, and the role of special needs plans. 38:00 – Why plans collect data, how risk coding works, and why beneficiaries should not fear appropriate data sharing for care management.
