More than 280 Physician Organizations Send Letter Urging CMS to Protect Medicare Advantage
MARCH 18, 2016
Letter Builds on Nationwide, Bipartisan Groundswell of Support for 17 Million Seniors in Medicare Advantage
Washington, D.C. – More than 280 provider groups recently signed a letter urging CMS to prioritize the well being of Medicare Advantage seniors in its final rate notice to be released on April 4th. The letter was organized by CAPG, a professional association representing multispecialty physician organizations nationwide.
The voices of physicians join those of more than 380 members of Congress and the 2 million Medicare Advantage beneficiaries with AHIP’s Coalition for Medicare Choices (CMC) in speaking out to protect the innovative, high quality care provided by Medicare Advantage.
Read highlights from the letter below:
- “[P]hysician organizations all across the country are committed to the transition from volume to value to meet Secretary Burwell’s ambitious delivery system goals… [W]e believe that MA is a critically important foundation for the movement into alternative payment models (APMs), and as such, must be funded wisely and appropriately.”
- “CMS must approach the phase in of encounter data with a high level of caution. It is essential that the agency ensure that this information accurately translates the risk of the population from the physician organization to the plan to CMS. We are concerned that not enough attention or testing has been done to ensure the reliability of data transmission and accuracy of data.”
- “Today, over 17 million seniors are enrolled in MA, nearly one-third of overall Medicare enrollment. We believe that this number will continue to grow as long as policy decisions support a strong future for this important Medicare option. We look forward to a final rate announcement that creates a strong MA program for the future.”
A new analysis from Oliver Wyman found that CMS’ proposed changes would result in an estimated 0.5 to 3.9 percent cut on average to Medicare Advantage payments in 2017. CMS’ proposed changes would increase the percentage of risk score calculations based on encounter data, a model which currently has unresolved operational and technical issues and fails to capture a reliable picture of beneficiaries’ diagnoses. This change alone, according to Oliver Wyman, could result in an up to 3 percent reduction in program funding.
“Such reductions, coupled with the reductions experienced in 2014 through 2016, could have a significant impact on the sustainability of Medicare Advantage Organization (MAO) program participation and the ability of MAOs to provide stable benefits and affordable premiums to their members,” the report states.
Earlier than ever this year, the CMC launched a digital advertising campaign and a coast-to-coast mobilization of its 2 million Medicare Advantage beneficiaries, who are contacting their elected representatives and urging Washington to protect their coverage from further cuts. Heading into the November election, seniors are making this a priority voting issue. Final Medicare Advantage payment rates are expected to be announced by CMS on April 4, 2016. Seniors will see the impact of new payment changes in late October 2016, when they begin enrolling in their 2017 Medicare Advantage coverage.