Better Medicare Alliance is the leading coalition on Medicare Advantage. Our mission is to build a healthy future by advocating for a strong Medicare Advantage.
As a community of experts, we are leading the way on health care through research, advocacy, and grassroots organization. Together, we are creating a path forward for innovative, modern health care.
Policy Priorities for Medicare Advantage
- Ensure consumer-friendly, enrollment materials on the choice and benefits of the Medicare Advantage program.
- Modernize the regulatory processes on rates and policies to support stability and ensure accurate payment in Medicare Advantage.
- Ensure high-quality care for beneficiaries with multiple chronic conditions.
- Promote innovation in care delivery through flexibility in benefits, plan design, community partnerships, and integrated care.
- Encourage value-based care by promoting value-based payment arrangements, insurance design, and aligning program goals and measurements.
Recommendations for Action
- Permanently authorize Special Needs Plans and expand the definition for use of supplemental benefits to offer services and support.
- Freeze the coding intensity adjustment at the current statutory minimum.
- Eliminate the benchmark cap for plans rated 4 stars or higher.
- Recognize value-based payment arrangements in Medicare Advantage as an advanced alternative payment model.
- Establish a formal Medicare Advantage stakeholder advisory group within the Centers for Medicare & Medicaid Services.
- Support increased funding for State Health Insurance Assistance Program counselors.
- Repeal the Independent Payment Advisory Board.
- Repeal or delay the Health Insurance Tax.
- Improve CMS and SSA beneficiary materials for initial and open enrollment.
- Eliminate barriers to flexible benefit design and expand the definition of supplemental benefits to include additional social supports and services.
- Account for social determinants of health in the calculation of risk scores and star ratings.
- Ensure smooth program transitions to Medicare Advantage through Employer Group Waiver Plans and seamless conversions.
- Delay the use of encounter data as the sole source of risk adjustment until identified data issues are addressed.
- Ensure accurate Medicare Advantage benchmark calculations by only using Fee-For-Service Medicare data from individuals enrolled in both Part A and Part B.
- Align the Medicare Advantage Star Rating System measures with other public quality rating systems.
- Implement a two-year policy-setting cycle for non-payment policy changes depending on geography.