Jonathan Blum

Jonathan Blum, deputy administrator and director at the Centers for Medicare and Medicaid Services, is touring the country to inform seniors of program changes. (Heather Charles/Chicago Tribune)

Medicare chief Jonathan Blum was in Chicago this week to get the word out about changes to the federal health insurance program, which begins open enrollment Saturday.

Among the changes this year: fewer health plans, lower premiums and an earlier deadline.

We sat down with Blum, deputy administrator and director of Medicare for the Centers for Medicare and Medicaid Services, to find out what the nearly 2 million Illinois residents enrolled in the program need to know. This is an edited transcript:

Q: Why did you travel to Chicago just before Medicare open enrollment?

A: We're going across the country (because) we at CMS want to make sure beneficiaries take an assessment of their health benefits every year. The time period for beneficiaries to decide whether they want to change their coverage starts Saturday, and it runs through Dec. 7. The timetable is sooner in the calendar than it was last year, so we want to make sure beneficiaries know about the change. It starts sooner, but the time frame is longer.

Q: What are the biggest changes in the program this year?

A: Benefits are stronger than they were a couple years ago. New benefits were added to emphasize wellness and prevention. We're working hard to shift the program's emphasis to be not just a program that cares for you when you get sick, but also one that keeps you healthy.

The prescription drug coverage is more generous than it was a couple years ago.

We believe choice is good, but too many choices oftentimes lead to confusion and to folks not making a choice. So we have reduced the number of (health plans) to place emphasis on the best possible choices.

Q: Why are changes being made to Medicare now?

A: Health care reform was broad sweeping and made very important changes for the Medicare program. One was that it added new benefits: a focus on wellness, a focus on prevention, a focus to make sure the Part D (prescription drug) benefit did not have any gaps in coverage.

Q: What about costs?

A: The health care reform legislation included a lot of provisions to reduce the overall costs of the program — not the benefits, but the costs. Many of the cost savings come from care improvements. We know that when care is improved, care is safer, care is better coordinated, and when you promote the quality of care, it's also going to reduce the cost of care, which is going to keep the program affordable over the long term.

Q: Is there any way to quantify the cost savings? Can you give an example?

A: Since Jan. 1, more than 1 million beneficiaries who receive benefits from the discount drug program (people who fell into the so-called doughnut hole) have saved $500 on average in out-of-pocket costs. In Illinois, it was $524 as of Aug. 5. Those numbers will increase over the course of the year.

Roughly 18 million beneficiaries across the country have access to free preventive and free wellness benefits with no out-of-pocket costs — no deductibles, no co-payments.

Q: What are the new star ratings all about?

A: We are putting in place new quality star ratings for health plans, now on our website, that beneficiaries can check. Plans that perform at the top of their game get five stars. The lowest rating is one star. Our goal is for all our benefits, our health plans, our hospitals, to assess the overall quality of the care they provide and also to tie our payments and reimbursement to those quality ratings.

Q: How many one-star and five-star plans are there in Illinois?