Letter: Medicare Advantage Should be Preserved

Originally published in The Herald Dispatch

As a nurse practitioner and retired commissioner of the West Virginia Medicaid program, I have come to value the importance of health care coordination and having a medical home. Having a medical home is a model of care in which patients are engaged in a direct relationship with a chosen provider, be they physician or advanced practice nurse, who helps coordinate the care. Included in this model should be a case manager to assist a patient navigating the health care system. Medicare Advantage offers these options for seniors who are covered by that type of Medicare plan.

Now, in Congress, there are some who are considering reducing federal funding for Medicare Advantage to pay for other proposed federal programs. If support for the program is reduced, premium costs may go up or services may be reduced. If premium costs go up, seniors might choose a system in which care is not coordinated to avoid the cost increase. This would leave seniors to fend for themselves in a complicated and confusing health care system.

For a state like West Virginia, which has some of the worst health statistics in the country, it is important to have programs that help manage a patient’s health, not just the current episode of care. West Virginia ranks as one of the highest in the nation for the prevalence of poor physical health, poor mental health, and activity limitations due to poor physical or mental health, according to a West Virginia Department of Health and Human Resources study from the Division of Health Promotion and Chronic Disease.

Many times, an episode of care is caused by a manageable health condition not being monitored and dealt with in a timely manner. Some examples are diabetic monitoring, high blood pressure and medication compliance. The care management/case management provided by the Medicare Advantage programs may identify the problem prior to it becoming a health care crisis.

Many great initiatives could be part of the federal reconciliation legislation; however, those should not come at the expense of a proven program such as Medicare Advantage. Many of our seniors have come to count on this type of health care plan.

I hope senators Joe Manchin and Shelley Moore Capito will fight efforts to cut funding for Medicare Advantage. More than 150,000 West Virginia seniors have chosen this type of coverage over traditional Medicare because of the additional benefits, including case management and having primary care providers that assist in care coordination.

Let’s not eliminate one of the best options for care for our country’s Medicare members.

Nancy Atkins is an advanced practice nurse and the retired commissioner of the West Virginia Medicaid program and was national chair for the National Association of State Medicaid Directors.