Medicare Advantage Helps Close Gaps in Care, Say Physician Leaders
Recent research from the Berkeley Research Group finds that Medicare Advantage delivers more preventive care and better health outcomes across populations when compared to Fee-for-Service Medicare — with higher rates of screenings and primary care visits and fewer avoidable hospitalizations.
To discuss what these findings mean for health care leaders and policymakers, Better Medicare Alliance spoke with two trusted voices in public health and champions of access to quality care for minority populations: Dr. Elena Rios, president of the National Hispanic Health Foundation, and Dr. Virginia Caine, president of the National Medical Association.
Their conversation offers timely insight into how Medicare Advantage’s emphasis on value-based, coordinated care is helping to deliver better outcomes and why protecting that progress matters now more than ever.
Better Medicare Alliance (BMA): This research looks at preventative care and outcomes across populations in both Medicare Advantage and Fee-For-Service Medicare. What stands out to you in the findings?
Dr. Elena Rios of the National Hispanic Health Foundation:
This research makes it clear that Medicare Advantage is helping more seniors access and benefit from primary care. It’s no surprise that improved outcomes follow. For older adults, preventative care can be the difference between catching a health issue early on or dealing with an emergency later. The report shows real improvements for our communities.
Dr. Virginia Caine of the National Medical Association:
The increased emphasis on screenings in Medicare Advantage is important. Preventive care helps physicians address the holistic drivers of a patient’s health, not just hand out prescriptions. Whether it’s managing chronic conditions or helping patients navigate their benefits, coordinated models like those in Medicare Advantage make it easier to deliver person-centered care.
BMA: What do you see as the importance of value-based care that Medicare Advantage supports, and what should health care leaders be aware of?
Rios: People underestimate the importance of coordinated care and team care. A visit to a clinic or medical office shouldn’t be just a one-off. Medicare Advantage involves more allied health, and this research shows it works.
Health care leaders should understand that we need more incentives, more convenience, and lower out-of-pocket costs. Screenings are less costly in Medicare Advantage, and that’s a great incentive for our people to go and access care.
Caine: Value-based care is the direction we need to go in because it’s based on results. Physicians can provide more social determinants services, looking at factors like transportation access and safe housing.
Paying more attention to a patient’s lifestyle is important. Without that, it will take us much longer to see improved health outcomes.
BMA: How do services covered by Medicare Advantage improve access to health care?
Rios: The Hispanic population includes very busy, large families with people more focused on taking care of others instead of themselves. Lower out-of-pocket costs and improved convenience help urge them to see a medical professional.
This is especially true for essential workers, who often just don’t have time to take care of themselves.
Caine: The cap on out-of-pocket expenses is helpful. Patients often have no idea what their medical bill is going to be. With the cap, it’s more comfortable to make and keep appointments. The extra benefits for prescription drug coverage, along with dental, vision and hearing services also make it easier.
Medicare Advantage is designed to meet the unique needs of seniors. To further this progress, the Medicare Advantage community can build on efforts to recruit providers of color — because patients experience better outcomes when they can connect with providers who share their culture and background.
BMA: What efforts are your organizations focusing on right now?
Rios: We have a strong interest in collaboration across the national Hispanic health professional organizations. We would like to have them work together in advocacy, especially increasing access for our populations and finding health equity gaps.
Caine: NMA is a collective voice of Black physicians. We try to be the leading force for parity and social justice in medicine, and we want to have a positive impact on eliminating health disparities. This research is critical to providing an assessment of where we are, so we can build on what we know.