Our Issues

Medicare Advantage provides seniors and people with disabilities high-quality, affordable health care that is flexible enough to meet their needs. That’s why we focus on Medicare Advantage in our research, and that’s why these issues below are our top focus this year.

 

Under Medicare Advantage, Special Needs Plans (SNPs) specialize care for the health care system’s fastest growing and most costly and complex care beneficiaries – frail, disabled, and chronically-ill Medicare beneficiaries.

Medicare beneficiaries count on their Medicare coverage to delivery high-quality care that meets their needs. Their ability to obtain high-quality care determines their health, happiness and peace of mind.

Medicare Advantage is built on a payment system that aims to move Medicare from a volume-based to a value-based system. The capitated framework in Medicare Advantage encourages a complete strategy of patient care to prevent unmanaged care that jumps from service to service.

There is wide variation in health and disease status within the Medicare population. To effectively treat these individuals, care must be customized to each of their unique health and social needs.

Millions of Medicare Advantage beneficiaries are denied the full value of a high-quality Medicare Advantage plan because of a technical provision known as the Benchmark Cap.

The Health Insurance Tax applies to individual policies, small groups, employers that are not self-insured, Medicaid managed care, Medicare Part D, and Medicare Advantage. Over 20% of the tax falls on Medicare Advantage and Part D plans, likely resulting in an increase in premiums and/or cost sharing paid by seniors and other beneficiaries.