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BETTER MEDICARE ALLIANCE COMMENDS CMS PROPOSALS TO INCREASE FLEXIBILITY & ENHANCE CARE IN MEDICARE ADVANTAGE

For Immediate Release

 

Washington, D.C.  Better Medicare Alliance (BMA), the leading advocacy coalition for Medicare Advantage submitted comments to Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma regarding proposed payment updates and policy changes for Medicare Advantage in CMS’ Advance Notice and Call Letter for 2019.

In the comment letter, BMA lauded CMS proposal to provide a positive and stable environment for Medicare Advantage plans, providers, and community partners to continue to lead the way in offering innovative, high-quality, cost-effective care that improves patient’s experience and outcomes.

Over the past year, BMA has worked to provide expert analysis, insight and stakeholder consensus on increasing flexibility under Medicare Advantage to meet the needs of millions of beneficiaries, particularly those that are chronically ill. Particularly, BMA has advocated for enhanced flexibility to include a wider range of supplemental benefits that improve care and address social determinants of health, such as nutrition assistance, in-home care, home modification, and transportation to medical appointments.

“We are pleased that CMS intends to not only allow Medicare Advantage to enhance supplemental benefits and allow for innovative approaches to meet critical needs but also eliminate barriers to flexible benefit design. Medicare Advantage payment systems and flexibilities are moving providers towards high-value care while improving the health care experience for physicians and their patients. We appreciate CMS’ support and engagement in the Medicare Advantage program,” said Allyson Y. Schwartz, BMA President and CEO in the letter.

In the letter, BMA expressed support for CMS’ intention to address two regulations, the uniformity and meaningful difference requirements, to allow Medicare Advantage health plans the ability to offer targeted supplemental benefits to better serve beneficiaries with specific needs and effectively customize care to improve patient outcomes.

Action from CMS is consistent with recent passage of the Bipartisan Budget Act of 2018 which allows greater flexibility needed for innovative care in Medicare Advantage. BMA intends to work with CMS as it develops guidance implementing this additional flexibility.

BMA also outlined the following priorities for policy changes for the 2019 calendar year: 

• Adjusting the payment methodology to account for different proportions of HMO vs. PPO plan types for Medicare Advantage employer-sponsored plans or Employer Group Waiver Plans (EGWPs)

• Delay of use of encounter data as a diagnosis source until data accuracy and processes are reliable

• Maintenance of the current coding adjustment methodology and to allow for a broader and deeper discussion of any change with stakeholders,

• Application of the statutory minimum coding pattern adjustment in 2019

 

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The 2019 Final Rate Notice and Call Letter will be released in April.

To access the full text of the BMA comment letter, click here.