Better Medicare Alliance Releases New Informational Materials on ESRD Coverage in Medicare Advantage

Washington, D.C. – Better Medicare Alliance, a community of more than 425,000 beneficiaries and 143 ally organizations supporting Medicare Advantage (MA), unveiled a suite of new informational resources on coverage of End-Stage Renal Disease in Medicare Advantage.

Currently, most individuals with End-Stage Renal Disease (ESRD) – also known as kidney failure – receive care through Traditional Medicare. Beginning in 2021, all patients will have the option to enroll in Medicare Advantage after a diagnosis of ESRD. 

As patients and health care providers await this change, an analysis from Avalere Health found that payments to Medicare Advantage for ESRD patients in highly populated regions “may be significantly below actual patient costs.” Better Medicare Alliance is championing updates to the Medicare Advantage ESRD payment methodology to ensure MA can deliver the quality care that ESRD patients deserve.

“Better Medicare Alliance is encouraged that, beginning next year, every ESRD patient will have the ability to experience the lower costs, improved care coordination, and better outcomes made available through Medicare Advantage. This is a change that can make a positive impact on the wellbeing of this group of seriously ill beneficiaries,” said Allyson Y. Schwartz, President and CEO of the Better Medicare Alliance. “As we plan for this transition, we must ensure that Medicare Advantage payment rates are adequate to cover the complex needs of these patients. These informational materials are made available to policymakers and stakeholders to support payment and policy changes that ensure Medicare Advantage has the tools needed to provide the highest quality coverage to every ESRD patient entrusted to its care. We urge the Centers for Medicare and Medicaid Services (CMS) to address such challenges in its Annual Rate Notice and Call Letter.”

ESRD informational materials provided by Better Medicare Alliance include:

• Fact Sheet: Preparing for End-Stage Renal Disease 2021 Enrollment into Medicare Advantage by Addressing Payment Adequacy
• Whitepaper: Caring for ESRD Beneficiaries in Medicare and Medicare Advantage
• Fact Sheet: Medicare Diabetes Prevention Program 
• Issue Brief: Analysis of End-Stage Renal Disease Payment Adequacy in Medicare Advantage

Learn more at bettermedicarealliance.org/End-Stage-Renal-Disease.

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