Better Medicare Alliance Urges CMS to Promote Stability for Medicare Advantage Beneficiaries in 2025 Final Rate Notice
Current medical trends should be appropriately accounted for to prevent program instability
WASHINGTON – Today, Better Medicare Alliance (BMA), the nation’s leading research and advocacy organization supporting Medicare Advantage, is urging the Centers for Medicare and Medicaid Services (CMS) to protect the stability of Medicare Advantage, a program supporting 32 million seniors and people with disabilities, by ensuring its CY2025 Final Rate Notice accounts for current health care utilization trends and the ongoing implementation of significant policy changes to the program. To do this, the Final Rate Notice should include more recent and complete data when determining the growth rate, and the calculation of the normalization factor should also be reconsidered. Together, these changes will promote stability in the MA program.
“There has been a notable increase in seniors using health care services from their doctors and providers, which makes sense given an increasingly aging population and the pent-up demand after the COVID-19 pandemic. At the same time, the Medicare Advantage program continues to adjust to significant policy changes, including the implementation of major changes to Part D. To ensure program stability for the 32 million beneficiaries who rely upon Medicare Advantage, adjustments should be made to appropriately account for these trends,” said Mary Beth Donahue, president and CEO of Better Medicare Alliance.
BMA’s comments are underscored by shifting dynamics in the health care landscape that impact patients and providers. These trends include cost increases from higher health care utilization rates, resulting from delayed care during the COVID-19 pandemic and an aging population. This year, 2024, will see the highest number of people turning 65 in the United States in history, a trend that is only expected to accelerate in coming years.
Additionally, the Medicare Advantage program continues to adjust to significant policy changes implemented in recent years, including modernizing the prior authorization process, new marketing regulations, and the phase-in of a new risk model enacted in 2023, along with additional changes to the way the program is administered and funded.
Healthcare stakeholders serving Medicare Advantage beneficiaries join in urging CMS to promote program stability:
“Over 69% of Hispanic seniors choose Medicare Advantage for the affordable, quality care it provides,” said Dr. Elena Rios, president and CEO of the National Hispanic Medical Association (NHMA). “NHMA and our 50,000 licensed Hispanic physicians join BMA’s call for a final rate notice that promotes a strong, stable Medicare Advantage program and advances health equity for our nation’s seniors.”
“Medicare Advantage is popular with seniors and their support for the program has pushed MA to record levels of enrollment,” said Jerry Penso, M.D., MBA, president and CEO of the American Medical Group Association. “As part of our nation’s commitment to these seniors, it’s important Medicare Advantage policies and payments reflect the increasing cost of delivering care and pent-up demand for services.”
“Vancouver Clinic shares BMA’s concerns with CMS’ Advance Notice. As a provider group of more than 500 multi-specialty clinicians serving Medicare Advantage beneficiaries, we have witnessed the increase in the number of seniors seeking health services and the resulting costs of care that CMS must account for,” said Mark Mantei, CEO of Vancouver Clinic. “To continue delivering quality, affordable care to the seniors we serve, it is critical that CMS protect the stability of the Medicare Advantage program in its Final Notice.”
“The agilon health Physician Network represents 2,400+ primary care providers in full-risk accountable care arrangements under MA Plans,” said Kevin Spencer, M.D., chief clinical officer at agilon health. “The strength and stability of the Medicare Advantage program is essential to our ability to drive value through better care, lower costs, and a focus on real outcomes. Moreover, our patients have access to health-changing clinical programs that are impossible to fund under fee-for-service. We are concerned the proposed rule would destabilize the ecosystem our providers depend on to effectuate CMS’ accountable care goals.”
BMA looks forward to engaging with CMS during the Advance Notice process on mutual goals of protecting the affordability and high quality of the Medicare Advantage program for the 32 million beneficiaries who rely on it, especially the low-income and those living in diverse, vulnerable communities.
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Better Medicare Alliance is a community of more than one million grassroots beneficiaries and 200+ ally organizations working to improve health care through a strong Medicare Advantage. Learn more at www.bettermedicarealliance.org.