How often have you heard, when getting Medicare data, “that does not include Medicare Advantage (MA) data in that report.”
MA, now representing over 50 percent of Medicare enrollment, is at the forefront of a push by the U.S. Department of Health and Human Services (HHS) to provide transparent data. HHS Secretary Xavier Becerra emphasized the importance of transparency in managed care plans in his recent statements, highlighting that lack of transparency deprives patients of vital information necessary for informed healthcare decisions. It also limits the ability of researchers and doctors to evaluate patient care trends and problems.
Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure asserts the Biden Administration’s commitment to improving the Medicare Advantage program. CMS has put out a Request for Information (RFI) in a step to align MA more closely with traditional Medicare, ensuring that the program meets the growing needs of enrollees.
This initiative is critical, as MA enrollment has surged; the government is expected to pay MA health insurance companies over $7 trillion in the next decade. The solicited information aims to ensure that MA plans effectively meet Medicare beneficiaries’ needs, provide timely care access, responsibly use taxpayer funds, and promote healthy market competition.
The RFI invites public input on various MA program aspects, such as access to care, prior authorization, provider directories, supplemental benefits, marketing, care quality and outcomes, value-based care, and the effects of vertical integration on payment. It also seeks suggestions on improving MA data collection and release methods. With an extended comment period of 120 days, the initiative encourages feedback from a broad spectrum of stakeholders.
Meena Seshamani, MD, PhD, CMS Deputy Administrator, stresses the importance of transparent Medicare Advantage data in driving high-quality care and competition. This RFI is a gateway for engaging all parties interested in the MA program.
What I think should be available:
The MA Data RFI is accessible on the Federal Register’s webpage, with comments due by May 29, 2024. This is a unique opportunity for stakeholders to contribute to shaping the future of Medicare Advantage, ensuring that it remains a robust, transparent, and competitive option for Medicare beneficiaries.
While attending the Florida Compliance and Privacy Consortium meeting, I was asked an excellent question. What if a patient who is ready for discharge from
We have been talking a lot lately about the malfeasance of Medicare Advantage (MA) plans, and deservedly so. But malfeasance can be a two-way street.
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