The recent CMS reforms aimed at reducing health disparities among MA beneficiaries are a strong start. Policymakers and stakeholders can help build on this foundation by advancing more complete data collection for evaluation, care delivery, and benefit design; aligning government programs to reduce gaps in care; and expanding retention efforts that support a diverse and culturally-competent health care workforce.

More publicly available information on access and utilization of supplemental benefits is needed to help inform future policymaking and maintain the goal of transparency. Enhancing how CMS collects data from MA plans and evaluates supplemental benefits in MA will help strengthen supplemental benefits for beneficiaries and guide future innovation.

As health care delivery increasingly shifts into the home, models of care must adapt while maintaining the high-quality care MA beneficiaries receive in a provider's office. In-home HRAs are used for preventative care and to assess the overall health of beneficiaries, document diagnoses, and identify gaps in care and unmet needs based on the information collected. BMA is committed to establishing robust, comprehensive best practices that will enable accountability, identify care gaps, and improve care coordination, particularly for those with complex health and social needs.

Ongoing challenges around the inadequate supply of behavioral health providers remain a major hurdle to improving access to behavioral care. As policymakers and stakeholders work to ensure access to reliable, high-quality, and comprehensive behavioral health care, they must first take steps to help build and support a diverse workforce to meet the growing demand of patients.

Creating accurate and beneficiary-focused provider directories is essential to supporting access to care, assisting beneficiary decision-making, and further coordinating and managing care. BMA is committed to working with policymakers and convening stakeholders to align on data elements and processes for a comprehensive and inclusive national directory to enable accurate and actionable information to support beneficiary decision-making.

The passage of the Improving Seniors' Timely Access to Care Act, supported by BMA, modernized the way MA uses prior authorization as a clinical tool to coordinate beneficiaries’ care. To further support MA beneficiaries in receiving high-quality and timely care, policymakers and stakeholders should continue to modernize and align utilization management and prior authorization requirements by establishing more efficient processes, electronic standards, and expedited decisions for requests.

Accurate health plan information empowers beneficiaries to make informed decisions about their coverage options. Establishing clear marketing guidance and best practices for stakeholders, including health plans, brokers and agents, and third-party marketing organizations, will support oversight and ensure beneficiaries receive complete and accurate information.