Modernizing Medicare through Medicare Advantage

Allyson Y. Schwartz

In the midst of the political debates about health care in America, Better Medicare Alliance hosted our third annual Medicare Advantage Summit last week. Throughout this two-day conference we heard first-hand how Medicare Advantage is leading the way in innovative financing and delivery of care that is the future of Medicare. The discussion was important to those who are directly involved in Medicare Advantage and potentially to all policymakers, Democrats and Republicans who care about ensuring quality, accessible and affordable health care for everyone.

There was a powerful sense of the energy and enthusiasm at the Summit expressed by providers, plans, new entrepreneurs and community organizations who are delivering innovative care to Medicare Advantage beneficiaries every day in this country. Over 22 million people are enrolled in Medicare Advantage and the numbers are growing. The discussions at the Summit centered around what is working best, what are we learning about how to improve care for beneficiaries and how by the new flexibilities will be used to address the social and functional needs of older adults to improve outcomes and their quality of life. During a fireside chat with me, Humana CEO, Bruce Broussard, explained his company’s focus on designing and offering new benefits aimed at addressing senior loneliness and food insecurity, two key social determinants of health.

The reports of this transformative care are impressive, including increased contacts with primary care teams, greater adherence to clinical protocols and prescription drug adherence, fewer ER visits and fewer hospital admissions. Medical groups and primary care clinicians, as well as beneficiaries are embracing this kind of care–finding it more patient-focused, more comprehensive, simpler and less expensive for the consumer. During one of our Spotlights on Innovation sessions, Dr. Griffin Myers with Oak Street Health provided an overview of Canopy, a web-based tool that enables providers to tailor their patients’ experience with the health care system. Only the value-based model of Medicare Advantage, he explained, affords them the ability to provide such patient-centered care.

And policymakers who were speakers and attendees spoke about the role of Medicare Advantage in driving value and higher satisfaction for beneficiaries. New ideas and the excitement around the future of Medicare was evident during sessions and in the hallways during every break.  This not only made for an interesting couple of days, but it made clear that the work being done in Medicare Advantage today should have an impact on the health care system we envision for the future.

Almost every day policymakers are talking about health care. They are seeking answers to the real issues facing consumers, including the concern about out-of-pocket costs, expense of prescription drugs, and lack of security around their coverage. We are proud of the fact that it is Medicare Advantage that is addressing the needs of and lowering costs for consumers in innovative ways and creating a model for the nation. From telemedicine to care in the home, Medicare Advantage is providing opportunities to give people the care they need while addressing clinical and non-clinical needs in integrated care systems at a cost that is the same or better than Traditional Medicare.

These new technologies and the promises they bring to monitor our health are exciting indeed and will likely enhance care and patient engagement. But we are also witnessing the modernization of care built on the most basic concepts that are essential to living healthier lives. Concepts like preventing illnesses, managing chronic conditions, and slowing disease progression that include the ability to access healthy foods, to exercise, socialize, to care for ourselves and access the providers we need.

A system of care that both incorporates the importance of technology and direct social supports is the future of Medicare.  It is a system that combines clinical care rooted in patient-centered primary care, with smart benefits based on value, tailored to patients’ needs, and responsive to each person’s individual wishes. It is a system that gives patients access to a team of doctors who track your health, anticipates the risk of disease and develops a plan of care to enhance your chance at the best quality of life—even as you age.

That is the kind of system of care available today in Medicare Advantage.

While there is much to be proud of in America’s health care, it is too often confusing, fragmented and costly. We know we can do better – and we are. Modernizing Medicare through Medicare Advantage is offering lessons that are already having a positive effect on the rest of health care.

At BMA’s Medicare Advantage Summit and in our latest report on State of Medicare Advantage, we highlighted the fact that with the right public policies and willing private sector partners, we can provide high quality, affordable care by building on the innovations and transformations happening today in Medicare Advantage.