Statement by HLC President Mary R. Grealy on CMS Proposed Changes Affecting Medicare Advantage Beneficiaries

Public Policy Should “Encourage Beneficiaries to Seek High-Quality, Cost-Efficient Coverage Options.”

(Dr. Kenneth Thorpe and Douglas Holtz-Eakin, co-chairs of the Partnership for the Future of Medicare, of which HLC is a member, have issued a statement on this issue.  It can be found here.)

We are encouraging the Centers for Medicare and Medicaid Services to reconsider its proposed changes in the methodology used to calculate payments to Medicare Advantage programs.  These changes, combined with funding reductions already being implemented as part of the Patient Protection and Affordable Care Act, could affect the financial viability of Medicare Advantage plans and make these valuable health coverage options less accessible for beneficiaries.

This would be an unfortunate development for both Medicare beneficiaries and our healthcare system.  A study published in December in Health Affairs found that Medicare Advantage enrollees experienced fewer emergency room visits, outpatient surgeries and inpatient hospital stays than beneficiaries in traditional fee-for-service Medicare.  The study’s authors wrote that Medicare Advantage plans were able to treat patients “with greater efficiency while attaining equal or superior quality.”

The thrust of federal health policy should be to encourage beneficiaries to seek high-quality, cost-efficient coverage options.  Medicare Advantage plans are delivering the desired objectives for our healthcare system – reduced cost escalation achieved through improved patient outcomes.  It makes little sense to enact changes that will drive beneficiaries toward conventional fee-for-service Medicare, for which payment and delivery reforms are being tested but not yet widely implemented.

CMS should revise these proposed changes and continue to offer Medicare beneficiaries broad access to Medicare Advantage.  These plans are currently serving approximately 14 million seniors and Americans with disabilities with the number of beneficiaries choosing Medicare Advantage growing everyday.

 

The Healthcare Leadership Council is a coalition of chief executives of the nation’s leading health care companies and organizations.  Follow us on Twitter at @HealthInFocus