Nearly one in three Medicare beneficiaries exercise their option to receive their Medicare benefits through Medicare Advantage (MA) Plans and Medicare-Medicaid Plans (MMPs). In addition to providing important coverage choices, a well-functioning MA program can do much more. In fact, the MA program can contribute mightily to health care delivery and payment reform. However, only in a policy environment that supports innovative, high-value care will Medicare Advantage realize its full potential.
The following steps are essential:
- Ensure MA payment accounts for the real costs of patient care, especially for frail and other high-cost populations.
- Restore Quality Incentive Payments impacted by the MA benchmark cap.
- Permanently reauthorize MA Special Needs Plans.
- Provide regulatory relief to certain site of service and telehealth restrictions for the purpose of improving the value and quality of patient care
- Promote consumer engagement in plan choice and innovation.
- Grant plans more flexibility to deploy targeted non-medical social services, behavioral health, long-term care, and other interventions not normally covered by Medicare.