The global dental implants market is expected to grow from $3.2 billion in 2010 to $4.2 billion in 2015 at a CAGR of 6% from 2010 to 2015. Europe currently forms the world’s largest market for dental implants with a 42% market share, and is also expected to have the highest CAGR, 7.0%, from 2010 to 2015.

While the lack of consumer awareness in developing economies may hinder market growth, industry players still have immense growth opportunities as merely 2% to 3% of the global edentulous population has already received dental implant treatment so far. The aging baby-boomer population in developed nations offers an especially high-growth opportunity, as this consumer segment is characterized by high disposable income, and also by an increased need for dental care due to longer life expectancy.

Global Dental Implants Market Report:

The report segments the Global Dental Implants Market based on:

– Dental Implants Market by Procedure

– Dental Implants Market by Material

This report on Global Dental Implants Market analyzes the market dynamics exclusively from the industry point of view. The report aims at providing a two-dimensional picture of the market by focusing on all aspects of the dental implants market by reporting the key trends, which are further analyzed at the micro market levels.

Each segment of the report will provide market tables, drivers, restraints and opportunities along with the key players and competitive landscape. This report will also provide more than 35 market tables for various geographic regions covering the sub-segments and micro-markets. In addition, the report provides 30 company profiles for dental implants manufacturers, etc.

Comprehensive market analysis for the following sectors:

Medical Devices, Pharmaceuticals, Biotechnology, Semiconductor and Electronics, Energy and Power Supplies, Food and Beverages, Chemicals, Advanced Materials, Industrial Automation, and Telecom and IT. We also analyze retailers and super-retailers, technology providers, and research and development (R&D) companies.

Key Questions Answered:

– Which are the high-growth segments/cash cows and how is the market segmented in terms of materials and procedure?

– What are market estimates and forecasts; which markets are doing well and which are not?

– Where are the gaps and opportunities; what is driving the market?

– Which are the key playing fields? Which are the winning edge imperatives?

– How is the competitive outlook; who are the main players in each of the segments; what are the key selling products; what are their strategic directives, operational strengths and product pipelines? Who is doing what?

Even the recession couldn’t vanquish vanity; steady consumer demand for teeth bleaching, tooth-colored fillings, implants and other cosmetic procedures has kept dentists smiling through today’s tough economic times. It’s also helped keep dental benefits popular and prompted some leading dental insurers to broaden plan coverage to include cosmetic services.

“More and more dentists see cosmetic procedures as a way to increase their revenue,” says Dr. Roma Virani, second vice president, Dental Cost & Utilization at Assurant Employee Benefits. For example, “most practices are doing tooth-colored fillings. It used to be that only a third of the fillings on back teeth were composites. Now that is reversed.

“While some people are concerned about the safety of amalgams,” she continues, “the switch is primarily driven by aesthetics. You get equally good results, so one type is not better than the other. However, people want their fillings to be tooth-colored so they are not as visible.”

Whitening leads the way

By far the most popular cosmetic procedure is teeth whitening. Dental magazines report that the most common conversation dentists have with their patients is about bleaching. Bradley Dykstra, DDS, wrote about the trend in Dental Economics magazine in April.

“The quest of baby boomers to stay forever young and society’s expectations to look our best drives this demand,” he says. “It is important to understand that patients, both male and female, want whiter teeth – period.”

Until a few years ago, bleaching was not covered by dental benefit plans. This changed when a handful of dental plan providers heeded requests from brokers and employers for voluntary insurance products that would offset the cost of cosmetic dental procedures for employees.

“All insurers in this industry are always looking for something new and different for brokers to sell,” says Kevin Martin, dental product development leader at Sun Life Financial. “Cosmetic was something the industry shied away from because it was not necessary care. Sun Life came up with the thought that since people want nice, shiny teeth, wouldn’t it be nice to offer a benefit that covers some, but not all, of the cost. I guess covering cosmetic was our iPod.”

Sun Life offers two cosmetic dental riders to its insurance plan. One covers teeth whitening done in the dental office or at home with products provided by the dentist. The other includes veneers as well as whitening.

The cost of the riders is based on the annual maximum selected and adds 3% to 6% to the standard dental insurance premium.

“It’s all about the smile,” maintains Paul Sherman, vice president and national sales director for American General Benefits Solutions, which began covering cosmetic procedures under its voluntary “Smile Maker” benefit plan two years ago.

Smile Maker currently covers teeth whitening and implants and will soon be expanded to include implants and composite fillings, according to dental product manager Sadia Zoppi. “It works like a lifetime orthodontia benefit for each family member,” she says. “About 2% of our business has this feature, but we anticipate that it will increase as more plan sponsors ask employees to contribute to the cost of their dental plan.”

The Smile Maker add-on is $8 per month for an individual and $32 per month for a family. “That can be a substantial increase in cost on a lower-priced dental plan that’s, say, $50,” notes Zoppi.

These products are expensive in nature, says so you’d expect this, says Zoppi. “But they are still very attractive, and they are meeting a need. There is a growing demand for these services.”

According to AACD, the mean amount spent by the average patient in 2006, the last year for which data is available, was $5,640 and the median was $3,860. At the high end, 3% of practices indicated an average amount spent per patient of $20,000 or more.

At the other extreme, 2% of practices reported average patient costs of less than $500. The most often indicated categories were $5,000-$9,999 (23%) and $2,500-$4,999 (22%).

Assurant Employee Benefits also was one of the first to cover teeth bleaching. Some of its plans also include posterior composites and porcelain crowns on posterior teeth, which it considers restorative rather than cosmetic.

“Going along with these trends, Assurant has come out with products that will take employees’ benefits farther,” says Virani. “We have Family Share Max and Preventive Max Waiver products that give more benefit dollars to plan members for these services. With the Preventive Max Waiver, preventive work does not count toward the annual maximum, so more dollars are available for non-preventive services.

“This supports our belief that if patients are getting preventive work done, they’ll need less restorative work in the future.”

Guardian broke new ground in 2004 when it extended coverage to implants. The company also offers coverage for whitening, posterior composites, porcelain inlays and onlays, and porcelain crowns and veneers.

“We take a lot of pride in customizing our plan designs to meet brokers’ and plan holders’ price points,” says Dr. Richard Goren, second vice president of Guardian’s group dental unit.

“There are hundreds of options. No one offers everything that we do.”

Brighter smiles, better health

Dentists view cosmetic dentistry not only as a means to increase revenue, but also as an important way to improve Americans’ oral health.

“If I want to whiten my smile, the dentist is going to talk about restorative needs before doing cosmetic work,” says Goren. “The motivation for a bright smile and white teeth is coming from the individual patients, and the drive for overall care is coming from the dentists.”

Like bleaching and tooth-colored fillings, implants improve patients’ appearance and promote self-esteem. But they also can help prevent problems down the road, Goren notes. “Bridge work involves shaving the tooth and cementing the bridge on top of it. When that happens, the tooth is never as good as when it was healthy. With an implant, no one is contributing to a tooth’s demise.”

Dermal filler next?

Dermal filler therapy may be a natural progression of where the cosmetic dental industry is heading, according to Goren. “With proper training, these procedures are easy for dentists to accomplish. Patients are motivated to accept these therapies and excited about having them done under local dental anesthesia, making dentists the health care professionals of choice to deliver these procedures.”

Whether dental plan providers will push the cosmetic coverage envelope to cover dermal filler therapy remains to be seen. Meanwhile, however, a new national movement is underway among dentists that could spark discussions about including cosmetic procedures as part of basic dental plans.

The dental industry has been lobbying across the country for states to prohibit insurers from negotiating discounts on services that are not covered.

Because there is a great deal of discounting on cosmetic procedures, this trend is significant, according to Evelyn Ireland, executive director of the National Association of Dental Plans in Dallas.

“The dentists feel that they are in an unequal, negative position,” she says. “Their position is if a carrier won’t pay toward a service, they shouldn’t be required to discount it.”

“The no-discounts on non-covered services legislation is not very consumer friendly,” says Virani. “If a service that is cosmetic in nature is not covered, the dentist will have better luck convincing the patient to have it done if it can be provided at a discount. Discounts are the cornerstone of PPO products, so this is changing things quite a bit.”

“Carriers aren’t happy [with these regulations] because employees are losing out on discounts,” agrees Martin. “It is possible that we’ll see a resurgence of requests for coverage for cosmetic services because then we could offer a discounted fee if that’s requested.”

Discounted or not, there’s no doubt that patients will continue to request cosmetic procedures and dentists will continue to expand the scope of these services.

“It’s a nice time to be a dentist when you have patients who are smiling, looking good and you know they have a healthy mouth,” says Guardian’s Goren. “It’s a stark contrast to getting feedback that it hurts and they don’t like anything you can do for them.”

By the numbers

In 2007, the American Academy of Cosmetic Dentistry put the market for cosmetic dental procedures at $2.75 billion, based on a 2006 survey of its members. Of that, $138.8 million was for bleaching and whitening, $383 million was for posterior composites, or rear fillings, and $144.3 million was for implants. The total number of patients seeking cosmetic services was estimated at 2.69 million, which represented a 12.8% increase over 2005. Furthermore, the survey respondents expected another 11% increase in patients and revenue in 2007.

Credit: By Lynn Gresham

The School-Based Oral Health Program, used in 10 local school districts from 2006 to 2009, was designed to bring the number of kids with cavities closer to 42 percent — a health benchmark set by the federal government.

But despite the school program, the percentage of Pierce County youngsters with cavities remained high: 56 percent overall and 65 percent for low income children.

There was “no evidence” the program reduced cavities in the total population of children, the Health Department’s internal assessment of the program concluded.

In the program, Health Department staff members examined the teeth of nearly 75,000 second- and third-graders, said David Vance, a Health Department division director. Children without cavities were offered a fluoride varnish or a dental sealant, Vance said. Those with decay were referred to low-cost dental providers.

Several factors contributed to the disappointing results, examiners said. Among them:

–Administrative problems. Only 18 percent of children who qualified for dental treatment received it.

–Failed sealant. Only about half of sealed molars remained fully sealed a year later.

–Economic recession: Tough times might have canceled out improvements

–High mobility: Only 28 percent of students assessed the first year were present for assessment two years later.

The Health Department will continue to explore strategies to prevent cavities in Pierce County children, Vance said.

Officials want to expand the sealant program to more children, find better ways to obtain parental approval and figure out a better way to apply sealants so they stay on molars longer.

Next year, Vance said, local dentists and their staffs will visit the schools instead of Health Department employees.

“We’ve reached out to private providers,” he said. “Rather than having Health Department staff go into the schools, we’ll be the ones coordinating the care. We’ll act as a clearinghouse. We think that will be a much more effective role for us.”

A “Smile Survey,” conducted by the Health Department in 2005, concluded the severity of dental decay was worse in Pierce County than the rest of the state.

In that survey, 37 percent of second and third graders had a history of decay in seven or more teeth (“rampant decay”), compared with 21 percent in all of Washington.

Among low-income preschool children, 39 percent had a history of decay in their upper front teeth, compared with 18 percent in the whole state.

A 2010 Smile Survey has just been finished and the results will be released later this month.

“That should give us a much better idea of where we are with the oral health of kids in Pierce County,” Vance said.

Rob Carson: 253-597-8693 rob.carson@thenewstribune.com

“The color looked a little different on one of the front teeth,” Garcia said. “I started looking to see what was wrong with that tooth.”

Tuesday morning, the Garcia family decided to take Daniel to the Wilson County Health Department to see what was wrong with the tooth.

Turns out little Daniel has a cavity on the back of that front tooth, said Valerie Brock, child public health nurse, after examining him.

The Wilson County Health Department has a new dental screening and fluoride varnishing program called “Into the Mouths of Babes,” which allows parents to bring in children as young as 6 months old to have a dental screening and fluoride varnish applied to the teeth.

The program, which is funded by the state, is for children up to 3 1/2 years of age and the treatments are suggested to be given every six months. The program started March 8.

“Getting the varnish is just like having a fluoride treatment at the dentist,” said Kay Long, child health coordinator. “We just put a very small amount of the varnish on the teeth and it sticks to the teeth until parents brush it off the next day.”

Long said the varnish tastes like bubble gum and the procedure doesn’t hurt the child.

“Children do make a fuss,” Brock said. “But it’s only because they don’t want you to go into their mouth.”

Brock said Daniel cried because he didn’t understand what she was doing.

“His father held him and comforted him,” she said.

Long said the sooner parents bring their children get the varnish, the fewer cavities they will probably have. She said studies show children receiving the procedure have fewer cavity-related treatments in a dental office than children who do not receive the treatment.

Brock said it also helps children to continue into adulthood with dental care when they start early.

Health department officials are trying to get more parents educated about why it is important for children to have regular dental check-ups.

“You would be surprised to know how many children don’t see the dentist,” Long said. “Statistics say 40 percent of children who start kindergarten have cavities.”

Long said many times children come to the health department for their well child check-ups needed to enter school and she finds their teeth and gums are in bad shape.

One reason very young children get cavities is because parents put babies to bed with a bottle.

“Milk has sugars in it and when a baby falls asleep with milk in his mouth, the sugar from the milk sits on the teeth,” Long said. “Toddlers also have sugary drinks in their sippy cups. All of those things cause cavities.”

Access to dental care for some parents is out of reach, Long said.

“There are not many pediatric dentists and only 25 percent of North Carolina dentists participate in Medicaid,” Long said. “So many children don’t get to see the dentist.”

It is not necessary for a child to receive any other health department services to get the dental screening services.

But the parent or guardian of the child must be present when the child gets the varnish.

“It is important that the person who cares for the child be here so they can learn first-hand about cavity prevention and what they can do,” Long said.

Appointments are not necessary. Walk-ins are welcome.

ADA Launches Community Dental Health Coordinator Pilot Program at Temple University

CHICAGO, Nov. 24 /PRNewswire-USNewswire/ — The American Dental Association (ADA) has signed an agreement with Temple University to train new dental team members as part of a pilot program to improve the oral health in underserved communities.

The Community Dental Health Coordinator (CDHC) is a member of the dental health team who works in communities where residents have limited access to dental care to improve their oral health.

The CDHC provides a limited range of preventive dental care services — including screenings and fluoride treatments. However, of greater importance to these communities, the CDHC will help patients navigate the health system and access care by a dentist or an appropriate clinic and engage in educational activities to improve community members’ oral health habits.

Temple will recruit and train CDHCs from urban locations in Philadelphia over the next two years, returning them to their communities to work as dental team members under the supervision of dentists.

Although the CDHC is a new dental team member whose merits are not yet known, many studies of the community health worker (CHW) model indicate that they can make significant contributions to a community. Because the CDHC will function much like a CHW, the ADA believes that they, too, will have a positive impact on the oral health of their communities through education and outreach.

“We are delighted to welcome Temple’s participation,” said ADA President Dr. Ron Tankersley. “The pilot at Temple will help us understand the effectiveness of a dental health coordinator in underserved urban settings.”

Dr. Amid Ismail, dean of Temple University’s Kornberg School of Dentistry and one of the architects of the CDHC program, explained why the program is seeking to place CDHC trainees in their own communities.

“Our aim is to ensure that the coordinator is able to bridge the gap between local cultures and health care systems. The CDHC can help improve people’s oral health habits and help patients navigate the social and bureaucratic barriers that prevent them from gaining access to available dental health services,” Dr. Ismail said.

Temple is the third of three pilot CDHC program sites. Two other pilot programs are directed by University of Oklahoma, which is training CDHCs from rural areas, and the University of California at Los Angeles, which, in conjunction with Salish Kootenai College in Montana, is training students from American Indian communities.

The ADA has funded the program, which will train six students per site each year.

About the American Dental Association

The not-for-profit ADA is the nation’s largest dental association, representing more than 157,000 dentist members. The premier source of oral health information, the ADA has advocated for the public’s health and promoted the art and science of dentistry since 1859. The ADA’s state-of-the-art research facilities develop and test dental products and materials that have advanced the practice of dentistry and made the patient experience more positive. The ADA Seal of Acceptance long has been a valuable and respected guide to consumer dental care products. The monthly Journal of the American Dental Association (JADA) is the ADA’s flagship publication and the best-read scientific journal in dentistry. For more information about the ADA, visit the Association’s Web site at www.ada.org.

SOURCE American Dental Association

Credit: American Dental Association

The BOE made its decision Tuesday, after it received more information about possible changes.

The members learned about joining a Preferred Provider Organization, updating the policy and changing to a usual and customary rate.

But BOE President Nancy Walker said they wanted to have the whole policy reviewed, instead of making changes over of several months.

“I’d prefer to do this once and not come back,” she said.

Walker said she would like to see the exact plan before making any changes. She has also spoken to her dentist and several procedures the plan covers are outdated.

Walker said she wants board members to look at what exactly they are covering.

The discussion comes on the heels of a board vote to reverse changes made to the dental plan.

On Sept. 22, the board approved changing the way dentists made charges.

The vote was not on the agenda and was brought up during discussion of increasing benefits in the employees’ vision plan.

Employees receive a $1,500 allotment for their dental coverage, Superintendent Frank Devono said.

For example, if an employee receives a teeth cleaning that costs $100, he or she would have $1,400 to pay for other procedures.

Amber Zackery, co-president of the Monongalia County Education Association, said she was happy the board said it made a mistake and rescinded the vote.

She thought that vote overshadowed the good news about the increase in optical benefits approved at the same meeting.

The organization is going to try to work with the administration to determine the best benefit plan for its employees, Zackery said.

She said she doesn’t oppose changes to any insurance package, as long as it benefits the workers.

The board was informed of two possible changes it could make. The first was switching to a Preferred Provider Organization (PPO).

With the switch, there would be no coverage changes and enrollees could visit any doctor, said Robyn Dilley, of American Benefits, administrator for the board’s policy. But employees who visit a dentist in the organization would receive a discount on the procedure’s costs.

The board decided against joining any organization without more research.

It also learned about usual and customary rate. Dentists are surveyed about a procedure’s cost and a maximum amount set that the insurance would pay for a procedure.

The patient would pick up any costs over the rate.

Of the more than 10,000 preventive care claims in the past year, Dilley said, more than 3,000 would have been over the rate.

But nearly 2,400 were $10 or less over the rate. She said many dentists don’t bill that small of an amount because it isn’t worth the time to recoup the money.

Devono said if they do make changes, board members would like to use the savings to improve the dental plan, either by increasing an employee’s allotment or by offering coverage on different procedures.

Board member Barbara Parsons said she would like them to look at their insurance policies every year to see if they need updating or changing.

“This isn’t something you can do overnight,” she said.

Credit: The Dominion Post, Morgantown, W.Va.

“We are delighted to have the opportunity to partner with these industry leading companies,” said Alan Miller, President and CEO of AMD LASERS. “Our customers are our greatest asset and creating such a high quality, value-added promotion will make their Picasso purchase experience even more pleasant and relevant to their business. At a value of almost $1,600, coupled with the world’s most affordable laser, we are confident this promotion will help with our goal of having a laser in every operatory.”

AMD LASERS, founded in 2006, is the global leader at providing comprehensive and affordable diode laser technology for dental professionals preparing to take their practice to the next level. The integration of Picasso, our high quality laser technology, enables thousands of dental practices to provide advanced patient care with ease. AMD LASERS customers also receive full-service customer care support from our knowledgeable and friendly staff. For more information about AMD LASERS, please call 866-999-2635, 317-202-9530, or visit us online at www.AMDLASERS.com.

At this year’s event, Oral-B will be exhibiting a new range of toothbrushes with Anti-Bacterial Bristle Protection, a technology which inhibits bacterial growth on bristles for up to three months. The new Oral-B Expert toothbrushes with Anti-Bacterial Bristle Protection use silver ion technology – a silver additive that is known to have antimicrobial properties. This allows for controlled silver-ion release and the constant introduction of new silver containing particles as the bristles wear during normal use. Silver ions are common antimicrobial agents and are used in a variety of different consumer and medical products.

Mr Azzawe believes Oral-B’s new technology will go along way to improving oral hygiene.

“Bacteria lives everywhere and in particular it grows on wet brushes after they have been used. Oral-B’s new technology helps to keep your brush clean and effective keeping acid erosion and cavities at bay.”

Oral-B works with dental professionals around the globe to develop products that are clinically proven to remove the most plaque and to promote oral hygiene. By showcasing this latest technology at Dentistry 2009, Oral-B will ensure that practitioners in the Middle East are aware of the most technologically advanced dental products and will be able to recommend the use of these products to their patients, saving time, money and unnecessary trips to the dentist.

“There will also be a corner devoted to Crest Expert Gum Protection, a new advanced toothpaste technology that shows improved product benefits that specifically addresses areas dentists care about enamel, gums and sensitivity,” says Mr Azzawe. “The toothpaste contains stannous fluoride which strengthens the enamel, in addition to reducing gum inflammation and tooth sensitivity. The formula is made novel with the addition of Sodium Hexa Meta Phosphate (SHMP) which protects teeth against staining.

“Dentistry 2009 is organised by IIR Middle East Life Sciences Division, the same organisation who brought the Arab Health Exhibition and Congress to Dubai. Oral-B associates itself with leading organisers in order to reach out to the industry professionals who attend an important meeting like this.” 2009 Al Bawaba (www.albawaba.com)

Traditional veneers require painful shots and irreversible removal of significant tooth structure, which can permanently damage teeth and cause sensitivity. “Treatment with Lumineers is virtually non-invasive. Coast Dental is excited to provide our patients with this safe option for customizing a smile that they will be proud to show off,” said Adam Diasti, D.D.S., president of Coast Dental.

The ground-breaking LUMITray technology makes completing a smile makeover fast and easy. Lumineers carries a five-year warranty. Schedule a Lumineers consultation at any Coast Dental practice in Atlanta. To locate the nearest practice call 1-888-COAST-44 or visit www.CoastDental.com/FindADentist.

Coast Dental offers patient financing with no annual fee and monthly payments starting as low as $25 for qualified patients. Coast Dental participates with over 200 dental insurance plans. Patients without dental insurance can save an average of 30 to 60 percent on most dental services by joining Coast Dental’s exclusive discount dental plan, Smile Plus(A), for a low annual fee. Contact the practice for details.

About Coast Dental

Coast Dental is the Southeast’s leading provider of dental services, with 28 affiliated offices in Georgia and 88 in Florida. Coast Dental Services, Inc. is a leading management company that provides comprehensive, non-clinical business and administrative services to its affiliated practices. The dentists are employees or independent contractors of Coast Dental of Georgia, P.C. For more information, visit www.CoastDental.com.

About Lumineers

Lumineers is the industry-leading, original ultra-thin veneer product made by Den-Mat Holdings, LLC, Santa Maria, California. Lumineers was listed as one of the Top 10 products by Dental Products Report and awarded five pluses in the Editors’ Choice Award by The Dental Advisor. For more information, call 1-800-445-0345 or visit www.Lumineers.com.

SOURCE Coast Dental Services, Inc.

Credit: Coast Dental Services, Inc.

Aetna Inc. has advised 8,500 area customers that it will terminate two of its Medicare Advantage plans at the end of this year. Independence Blue Cross has given the same notices to 44,000 individual subscribers who depend on four plans it offers.

Other insurers in other markets are also making cuts.

Meanwhile, area offices for the aging are being swamped with calls as worried senior citizens try to figure out whether their plans are affected.

“People are calling in tears,” said Kim Andrews, director of a program with the Delaware County Office of Services for the Aging that helps the elderly sort out insurance options.

Both companies continue to offer other Medicare Advantage plans, and both also sell “Medigap” insurance, a supplement to Medicare.

“I’m upset, and so is my wife,” said retired banker Joe McGough, 77, of East Falls, who received a letter from Aetna earlier this month.

“We haven’t been that sick, and we’re not costing them hardly anything,” McGough said. “Maybe it has something to do with [President] Obama and all that health reform.”

Health economist Mark V. Pauly at the University of Pennsylvania’s Wharton School had a similar assessment. “Maybe they are just trying to tidy up before the storm,” he said.

With Congress looking to Medicare savings to bankroll its plans for health reform, insurers around the country that sell Medicare Advantage plans are cutting back their offerings for 2010, saying federal reimbursements are too small.

Reimbursements for Medicare Advantage plans will be down 4 percent, the insurers said, even as medical costs for doctors and hospitals continue to increase.

“We had to take a hard look at our plans,” said Eric Cormier, general manager of Aetna’s Mid-Atlantic region and retiree markets.

Nationally, 24.2 percent of the 45.5 million people who qualify for Medicare use Medicare Advantage plans. Medicare is primarily federally funded health insurance, but its coverage has gaps.

Under Medicare Advantage programs, the government subcontracts with insurance companies to handle the paperwork, manage the care, fill in the gaps, and provide various extra services, such as drug and dental plans. The insurers also charge premiums and co-pays.

The federal government pays the insurers an average of 12 percent more than it would cost to fund plain-vanilla Medicare. Reimbursement varies by county, depending on costs.

Rural areas usually get more, and Medicare also provides reimbursements to hospitals handling caseloads of poor patients who cannot pay.

But policymakers in Washington have been looking at that extra reimbursement, seeing it as part of the way to fund increased coverage.

A Congressional Budget Office analysis of the Senate Finance Committee bill sees $404 billion of the $829 billion 10-year price tag coming from savings in Medicare and two other programs. An earlier analysis suggested that Medicare changes would provide 10-year savings of $460.3 billion. Of that, $124.3 billion would come from changes to the Medicare Advantage plans.

In a House version of the bill, Medicare Advantage savings would amount to $172 billion over 10 years, according to an analysis by the Kaiser Family Foundation.

Pauly said Medicare Advantage plans were caught in an ideological shift. Democrats would like to see private insurers out of the Medicare business, he said. “Payments have been reduced, and they are on the chopping block going forward.”

Medicare, he said, “is both the model and the stalking horse for single-payer insurance.”

Despite the cuts, insurers want to stay in the senior-citizen market, especially in a state such as Pennsylvania, with its large elderly population.

“The demographics are there,” said Jason Feuerman, senior vice president and executive director of Bravo Health Pennsylvania in Philadelphia. Bravo is a Maryland-based company that sells only Medicare Advantage plans, specializing in HMO coverage. It is expanding its local reach.

In the Philadelphia area, cuts by Independence Blue Cross affect just over a third of its 133,500 individual Medicare Advantage subscribers.

Aetna is eliminating plans covering 6,500 individuals in Philadelphia and its suburbs, or 19 percent, and 1,000 in nearby New Jersey counties, or about 12 percent.

Both insurers are eliminating plans that serve elderly subscribers poor enough to qualify for Medicaid. Aetna’s plan serves 1,000; the Independence Blue Cross plan serves 19,000.

These are the main plans to be cut: Aetna’s Medicare Golden Premier PPO plan and Independence Blue Cross’ Keystone 65 Complete, Keystone 65 Value across the region, and Personal Choice PPO 65 for subscribers in Chester, Delaware, and Montgomery Counties.

In Philadelphia and Bucks County, Independence Blue Cross’ Personal Choice PPO 65 plans will continue.

Contact staff writer Jane M. Von Bergen at 215-854-2769 or jvonbergen@phillynews.com.

Credit: The Philadelphia Inquirer