Policy Recommendations

Better Medicare Alliance is the leading coalition on Medicare Advantage. Our mission is to build a healthy future by advocating for a strong Medicare Advantage. 

As a community of experts, we are leading the way on health care through research, advocacy, and grassroots organization. Together, we are creating a path forward for innovative, modern health care.

Policy Priorities for Medicare Advantage 

  • Ensure consumer-friendly, enrollment materials on the choice and benefits of the Medicare Advantage program.
  • Modernize the regulatory processes on rates and policies to support stability and ensure accurate payment in Medicare Advantage.
  • Ensure high-quality care for beneficiaries with multiple chronic conditions.
  • Promote innovation in care delivery through flexibility in benefits, plan design, community partnerships, and integrated care.
  • Encourage value-based care by promoting value-based payment arrangements, insurance design, and aligning program goals and measurements.

Recommendations for Action

Legislative Actions:

  • Permanently authorize Special Needs Plans and expand the definition for use of supplemental benefits to offer services and support.
  • Freeze the coding intensity adjustment at the current statutory minimum.
  • Eliminate the benchmark cap for plans rated 4 stars or higher.
  • Recognize value-based payment arrangements in Medicare Advantage as an advanced alternative payment model.
  • Establish a formal Medicare Advantage stakeholder advisory group within the Centers for Medicare & Medicaid Services.
  • Support increased funding for State Health Insurance Assistance Program counselors.
  • Repeal the Independent Payment Advisory Board.
  • Repeal or delay the Health Insurance Tax.

 

Regulatory Actions:

  • Improve CMS and SSA beneficiary materials for initial and open enrollment.
  • Eliminate barriers to flexible benefit design and expand the definition of supplemental benefits to include additional social supports and services.
  • Account for social determinants of health in the calculation of risk scores and star ratings.
  • Ensure smooth program transitions to Medicare Advantage through Employer Group Waiver Plans and seamless conversions.
  • Delay the use of encounter data as the sole source of risk adjustment until identified data issues are addressed.
  • Ensure accurate Medicare Advantage benchmark calculations by only using Fee-For-Service Medicare data from individuals enrolled in both Part A and Part B.
  • Align the Medicare Advantage Star Rating System measures with other public quality rating systems.
  • Implement a two-year policy-setting cycle for non-payment policy changes depending on geography.