At a time of transition in health care coverage across our country, it is important that seniors and people with disabilities retain the health care coverage on which so many of them depend: Medicare Advantage.
Unfortunately, the administration has undercut this essential program by proposing harmful cuts to Medicare Advantage.
More than 15 million seniors and individuals with disabilities have voluntarily chosen Medicare Advantage plans nationwide. That’s more than a quarter of the people who are enrolled in Medicare. And in my home state of Arizona, there are 391,210 people benefiting from Medicare Advantage.
I hear firsthand from Southern Arizona seniors that Medicare Advantage is working for them. And the same is true for seniors across our nation. In fact, in national surveys an overwhelming 98 percent of enrollees report that they are satisfied with their care management. And 95 percent of members rate their overall quality of care as very high. In addition, nearly 9 out of 10 members believe their plan helps them live a healthier life.
Medicare Advantage is a rare program that has delivered great results under budget. It accounts for 67 percent of projected Medicare savings. Plans vary from region to region, but generally these plans offer extra benefits to seniors and require smaller co-payments or deductibles than the original Medicare. They also provide seniors with a user-friendly alternative to more expensive and complicated supplemental insurance plans in the private market.
Now, unfortunately, Medicare Advantage again faces cuts in reimbursement rates that will harm the success of this program and the benefits it provides in our communities.
When MA cuts its reimbursement rates, plans recoup their losses by paying doctors less, charging consumers more — or both.
Even before these latest cuts were announced, beneficiaries were facing difficulties because of the final 2014 rate cut of 6.7 percent included the Medicare “doc fix.” Enrollees already were looking at an average 13 percent Medicare Advantage rate cut over two years compared with 2013.
Seniors simply cannot afford this latest round of cuts to Medicare Advantage.
What will these further cuts mean to this successful program? These new cuts will decrease access to the innovative services and benefits that seniors have come to rely on, such as coordinated care systems that provide integrated health care services and preventive care and disease management services for those with chronic conditions.
Medicare Advantage plans reduce hospitalizations and readmissions, decrease the length of stay in nursing facilities and manage high-risk, high-need patients more effectively.
Plus, Medicare Advantage has a proven track record of bringing innovation and improving treatments.
Studies show that Medicare Advantage enrollees have better health outcomes and receive higher quality care than their counterparts in traditional Medicare, which lacks care coordination.
For example, a 2013 study published in Health Affairs found that Medicare Advantage plans’ outcomes for breast cancer screening, diabetes care and cholesterol testing were consistently better than the traditional fee-for-service Medicare patients.
Another study, published by the American Journal of Managed Care in February 2012, found that the hospital readmission rate for Medicare Advantage enrollees was about 13 to 20 percent lower than for Medicare fee-for-service enrollees — a sign that these plans are helping patients avoid harmful complications.
Not only do Medicare Advantage plans ensure patients receive appropriate care, but they also save beneficiaries money by capping their out-of-pocket expenses — something many seniors have come to rely on during these challenging economic times.
If this latest round of cuts goes into effect as proposed, out-of-pocket expenses could increase significantly for a population that on average earns less than $20,000 per year. Additionally, unless the rate cuts are stopped, benefits may be further reduced, provider access may become more limited and plan options may be reduced.
Given the success of Medicare Advantage in improving health and saving money for millions of the most vulnerable Americans, I am urging the administration to reverse course and keep Medicare Advantage rates stable to ensure the sustainability of this critical program for our nation’s seniors and people with disabilities.
Democratic Rep. Ron Barber represents Arizona’s 2nd District.