At a time when a broad debate over the future of value-based care delivery and payment has emerged in the U.S. healthcare system, a bipartisan majority of U.S. senators expressed their support for the Medicare Advantage program, in a public letter to Chiquita Brooks-LaSure, Administrator of the Centers for Medicare and Medicaid Services (CMS).
On Friday, Feb. 18, 63 senators, led by Senators Catherine Cortez-Masto (D.-Nevada) and Tim Scott (R-South Carolina), signed the letter addressed to Administrator Brooks-LaSure. The Washington, D.C.-based Better Medicare Alliance, an advocacy group that describes itself on its website as “a community of experts leading the way forward on health care, driven by our common goal to support Medicare Advantage,” announced the letter’s production, in a press release posted to its website and entitled, “Medicare Advantage Clinches Historic, Bipartisan Support in U.S. Senate Letter.”
The press release began thus: “Better Medicare Alliance, the nation’s leading research and advocacy organization supporting Medicare Advantage, applauded the historic showing of bipartisan support for Medicare Advantage in the U.S. Senate this week, as evidenced by a new Senate letter to the Centers for Medicare & Medicaid Services (CMS).The letter, led by Sens. Catherine Cortez Masto (D-NV) and Tim Scott (R-SC), was signed by 63 members of the U.S. Senate altogether. It comes as CMS prepares to finalize its Medicare Advantage rate announcement for 2023, expected by April 4.In their letter, the Senators urge CMS to “ensure that payment or policy changes allow Medicare Advantage plans to continue to provide the patient-centered care that 43 percent of Medicare-eligible Americans rely on every day.”The lawmakers go on to laud Medicare Advantage’s “high-quality care and value that provides beneficiaries with more coordinated access to enhanced benefits, innovative clinical care models, and greater financial protections” while affirming their commitment to ‘ensuring that our constituents who rely on Medicare Advantage enjoy the same access to affordable benefits in order to get the care they need.’ The letter follows similar correspondence sent last month from 346 bipartisan members of the U.S. House of Representatives.”
In the letter to Administrator Brooks-LaSure, whose full text can be accessed here, the senators wrote:
“We write to express bipartisan support for the Medicare Advantage program and the high-quality, affordable care it provides to over 27 million older adults and people with disabilities. We appreciate the Administration’s ongoing commitment to preserve and strengthen the program, as demonstrated in the proposed CMS 2023 Medicare Advantage and Part D Advance Notice. As you consider annual updates for plan year 2023, we ask you to ensure that payment or policy changes allow Medicare Advantage plans to continue to provide the patient-centered care that 43 percent of Medicare-eligible Americans rely on every day. The Medicare Advantage program enables plans to take a holistic approach to care, including by addressing social determinants of health to meet seniors’ needs and improving health equity. Enrollees in the program benefit from out-of-pocket cost limits and plan options that can include access to telehealth services, in-home care, nutrition services, and transportation benefits to meet seniors’ individual needs. In fact, over 95 percent of Medicare Advantage beneficiaries have access to meal services, telehealth, transportation, dental, fitness, vision, and hearing benefits. Access to these benefits and care provided under the Medicare Advantage program have helped enrollees stay healthy and safe throughout the ongoing COVID-19 pandemic.”
Further, the senators wrote, “ Medicare Advantage also consistently delivers high-quality care and value that provides beneficiaries with more coordinated access to enhanced benefits, innovative clinical care models, and greater financial protections. Currently, 90 percent of enrollees are in Medicare Advantage plans rated 4 or more Stars. Additionally, the program supports an increasingly diverse population with varied health and socioeconomic backgrounds. For 2022, 65 percent of MA enrollees are in zero premium plans and the average monthly Medicare Advantage premiums will reach historically low premiums, even while the availability of supplemental benefits continue to increase. For plan year 2023, we urge the Administration maintain stability within Medicare Advantage, including advancing flexible in-plan benefit offerings and promoting care coordination. We are committed to ensuring that our constituents who rely on Medicare Advantage enjoy the same access to affordable benefits in order to get the care they need, particularly as they navigate the persistent challenges of the pandemic. We look forward to partnering with you and working on behalf of the tens of millions of older adults and people with disabilities whose health and economic security are protected under this program.”
The letter was not penned in a vacuum; a broad debate over the future of value-based programs sponsored by the federal government has emerged in the several months since Donald Berwick, M.D. and Richard Gilfillan, M.D., wrote a Health Affairs blog excoriating elements of the Medicare Advantage program, the Direct Contracting Program, and accountable care organizations, in published online on Sep. 30, 2021. Their blog, entitled “Medicare Advantage, Direct Contracting, And The Medicare ‘Money Machine,’ Part 2: Building On the ACO Model,” ignited a rhetorical firestorm in healthcare policy and payment circles. As the former Acting CMS Administrator and former Director of the Center for Medicare and Medicaid Innovation (CMMI), respectively, their blog created a huge amount of discussion, and further, led to an effort on the part of some members of the House of Representatives, led by Reps. Pramila Jayapal (D-Wash.) and Katie Porter (D-Calif.) to write to Health and Human Services Secretary Xavier Becerra, asking that he end direct contracting under Medicare. Leaders of groups including America’s Physician Groups (APG), NAACOS (the National Association of ACOs), and Oak Street Health, have been asserting the value of value-based contracting under Medicare, as Managing Editor Janette Wider reported in a Feb. 18 report.
