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The Issues

We focus our work on these issues, which we believe are driving the future of health care for seniors. As the leading voice on Medicare Advantage, we work tirelessly to protect and ultimately strengthen this critical health care. Our thoughtful, data-driven research drives powerful action in the halls of Congress, from Issue Briefs to Letters on behalf of our community.

The Fight Against COVID-19

As of this writing, more than 150,000 Americans have lost their lives due to COVID-19 – with seniors and those with disabilities among those most at-risk. Better Medicare Alliance advocates for solutions to ensure Medicare Advantage has the tools it needs to keep seniors safe in this uncertain time.

  • Report: “Spotlight on Innovation: The Response to COVID-19”  (June 24, 2020)
  • Fact Sheet: Medicare Advantage Medical Loss Ratio (June 19, 2020)
  • Letter: “Better Medicare Alliance Writes to HHS and CMS on Policies to Ensure Stability for Medicare Advantage Amid COVID-19” (April 27, 2020)
  • Press release: “Better Medicare Alliance Secures Key Protections for Beneficiaries in CMS COVID-19 Announcement.” (March 31, 2020)
Racial Disparities in Health Care

As a diverse community of Ally organizations and beneficiaries, Better Medicare Alliance has a keen focus on addressing racial disparities that persist across the health care spectrum and bringing the tools uniquely found in Medicare Advantage to bear in the effort to achieve true equality in health care.

Rebate Rule

First proposed in early 2019, the Trump administration has recently revived a flawed, pharmaceutical-industry favored plan effectively banning rebates used to lower the final cost of a drug from the list price offered by drug manufacturers. The administration’s own actuaries found that the plan could raise Medicare Part D premiums by 19 percent in the first year, and 25 percent in the decade thereafter. Further, a 2019 analysis from Avalere Health found that eliminating prescription drug rebates would “have the consequence of increasing beneficiary premiums and reducing benefit offerings by Medicare Advantage-Prescription Drug (MA-PD) plans.”

Better Medicare Alliance led the successful charge to shelve the rebate rule in 2019 and will do so once more. Read more for our latest resources on the need to stop the flawed rebate rule and pursue real solutions to lower prescription drug costs that don’t carry unintended consequences for vulnerable seniors.

  • Press Release: Better Medicare Alliance decries executive order reviving flawed rebate rule (July 24, 2020)
  • Letter: Better Medicare Alliance writes to HHS Secretary Alex Azar urging against restarting rebate rule efforts (July 21, 2020)
  • Report: Impact of Proposed Rule to Eliminate Prescription Drug Rebates on Medicare Advantage Beneficiaries (April 2019)
  • Fact Sheet: The HHS Rule to Eliminate Manufacturer Rebates in Part D Will Harm Medicare Advantage (April 2019)
Telehealth

Telehealth is already improving access to health care across Medicare Advantage. Even before the onset of the COVID-19 pandemic, an actuarial analysis commissioned by Better Medicare Alliance found that over two-thirds of Medicare Advantage plans provided telehealth as a supplemental benefit. Now, with new flexibilities granted to ease adoption of telehealth in the face of the current COVID-19 crisis, a poll conducted by Morning Consult for Better Medicare Alliance finds that 91% of seniors on Medicare Advantage who use this technology report a positive experience.

  • Fact Sheet: Benefit Flexibilities Granted to Medicare Advantage Amid the COVID-19 Crisis (includes those related to telehealth) (May 21, 2020)
  • Letter: Better Medicare Alliance writes to CMS on allowing audio-only telehealth visits for risk adjustment purposes (June 2, 2020)
  • Blog Post: BMA Seniors Tell us Their Telehealth Stories (June 9, 2020)
Improving the Medicare Enrollment Process

Better Medicare Alliance is leading the charge for solutions to streamline the Medicare enrollment process and ensure that all beneficiaries know of the option of Medicare Advantage so they can be active choosers in their health coverage. Already, our advocacy efforts led to additional anguage in the annual “Medicare & You” handbook that includes easy-to-read, upfront comparisons of Medicare Advantage and Traditional Medicare. We also worked with leaders in Congress like Rep. Jimmy Gomez (D-CA) to urge the Centers for Medicare & Medicaid Services (CMS) to increase the number of languages used in Medicare’s educational and enrollment materials.

  • Op-Ed: “Open enrollment season for Medicare can be confusing but worth the effort” (November 6, 2019)
  • Press Release: “Congressman Jimmy Gomez Leads Letter to Expand Medicare Language Access” (May 14, 2019)
End-Stage Renal Disease

In addition to individuals age 65 and older and people with disabilities, Medicare covers people with End-Stage Renal Disease (ESRD), also known as kidney failure. ESRD occurs when an individual’s kidneys permanently and completely stop functioning. By 2021, all Traditional Medicare beneficiaries with ESRD will be allowed to enroll in Medicare Advantage. While Better Medicare Alliance secured a number of key solutions to improve care for ESRD beneficiaries, a payment gap remains that could result in Medicare Advantage failing to recoup the full cost of these beneficiaries’ care. Accurate payment for ESRD enrollees protects all Medicare Advantage beneficiaries from higher costs or fewer opportunities to expand and improve supplemental benefits.

  • Press Release: “Better Medicare Alliance Urges Fairness for ESRD Patients, Backs Telehealth Reforms in CMS Advance Notice Letter” (March 6, 2020)
  • Issue Brief: “Analysis of End-Stage Renal Disease Payment Adequacy in Medicare Advantage” (December 13, 2019)
  • Fact Sheet: Preparing for End-Stage Renal Disease 2021 Enrollment into Medicare Advantage by Addressing Payment Adequacy (January 14, 2020)
Value-Based Care

Medicare Advantage is built on a value-based system in which Medicare Advantage health plans receive a per-member, per-month payment for each beneficiary’s care, and are tasked with using those dollars most effectively – incentivizing high quality, high-value care for the 24.2 million enrollees who trust Medicare Advantage with their health care needs.

Our President and CEO, Congresswoman Allyson Y. Schwartz, penned a four-part blog series for Health Affairs about how Medicare Advantage’s value-based structure works to serve beneficiaries, which you can read below:

Additionally, Better Medicare Alliance publishes a report series entitled “Spotlight on Innovation” which has detailed advances in health care made possible by Medicare Advantage’s value-based structure. Recent reports include:

Consumer Costs

Keeping consumer costs low for consumers is at the heart of Better Medicare Alliance’s mission, and is among the many reasons why more than 24 million Americans trust Medicare Advantage with their health coverage today. Survey data shows that Medicare Advantage beneficiaries report $1,598 less in total annual health expenditures than their Traditional Medicare counterparts. Read more about the cost savings found in Medicare Advantage below:

  • Press Release: Medicare Advantage Beneficiaries See Lower Costs Across Sites of Care (May 13, 2020)
  • Press Release: Medicare Advantage Saves Beneficiaries Nearly $1,600 A Year (March 10, 2020)

Special Needs Plans

Special Needs Plans (SNPs) are a type of Medicare Advantage plan that specializes in care for the health care system’s fastest-growing and most costly and complex beneficiaries: frail, disabled, and chronically-ill Medicare beneficiaries. SNPs are authorized to tailor services and models of care to the unique population they serve through the Medicare Advantage framework.

Benchmark Cap

Three million American seniors will be denied critically important benefits like care coordination, vision, dental, hearing, and wellness programs. If Washington allows the Cap to stay in place seniors will be negatively impacted, facing higher costs and fewer benefits. At Better Medicare Alliance, we use the power of our allies to urge Congress and CMS to lift the cap, thus giving beneficiaries higher-quality care.

  • Fact Sheet: The Impact of the Medicare Advantage Benchmark Cap on Beneficiaries (June 29, 2018)
  • White Paper: The Impact of the Medicare Advantage Benchmark Cap on Beneficiaries (October 28, 2016)
Health Insurance Tax

BMA VICTORY: The Health Insurance Tax applied to individual policies, small groups, employers that are not self-insured, Medicaid managed care, Medicare Part D, and Medicare Advantage. Over 20% of the tax would have fallen on Medicare Advantage and Part D plans, likely resulting in an increase in premiums and/or cost sharing paid by seniors and other beneficiaries. Better Medicare Alliance led the successful fight for permanent repeal of the Health Insurance Tax in 2019, safeguarding millions of seniors from the threat of punishing taxes on the health coverage they depend on to stay well.