Many ACHP members offer Medicare Advantage plans – in all, ACHP members enroll about 12 percent (more than 2.6 million) of the 22.4 million Medicare Advantage members.

Our plans are amongst the highest quality plans in the nation, scoring four or more stars in the Medicare Star Quality ratings. ACHP advocates on behalf of improved care coordination for beneficiaries in Medicare Advantage as well as innovative health care delivery models such as telehealth. ACHP’s advocacy efforts also include restoring quality incentive payments to community plans to ensure the highest scoring plans are rewarded for their performance.

Medicare Advantage Infographic ACHP’s nonprofit, community-based health plans provide the highest quality MA coverage to seniors nationwide. To learn more about MA and our plans’ performance, click here.

Medicare Advantage Quality payments

Since 2009, enrollment in Medicare Advantage (MA) programs has doubled to more than 22 million Americans – more than 37 percent of all Medicare beneficiaries.

Medicare Advantage plans are held to important quality measures with those achieving the highest quality ratings being rewarded with a quality incentive payment. The program was designed to improve quality and value by offering bonus payments to plans providing the highest quality care. Importantly, plans reinvest quality bonus dollars into member services, improving benefits and reducing premiums. However, due a cap on these payments, many of the best MA plans are receiving only a fraction or, in some cases, no bonus payments at all. In the end seniors lose.

That’s why ACHP proudly supports the Medicare Advantage Quality Payment Relief Act, sponsored by Reps. Ron Kind (D-WI), Mike Kelly (R-PA), Mike Doyle (D-PA), Brett Guthrie (R-KY) and Sens. Steve Daines (R-MT) and Angus King (I-ME). The bill, which has broad bipartisan support, would allow a more accurate comparison of benchmarks and restore quality payments to the highest performing 4- and 5-star health plans. The bill is critical to ensuring value in the Medicare Advantage program.

Letter to Ways and Means Committee on mark-up for exploration of fix to benchmark cap, June 2018
Letter to Ways and Means Subcommittee on Health on addressing barriers to innovation in health care, April 2018
Letter to House of Representatives regarding solution to Benchmark Cap issue, November 2016
Letter to Senate regarding solution to Benchmark Cap issue, November 2016 

Improved Care Coordination

ACHP advocates for innovative and cost effective approaches to caring for those receiving Medicare benefits with the goal of improving health outcomes. Our efforts are focused on the reauthorization of Special Needs Plans, expansion of telehealth in Medicare Advantage, restoring quality payments under the MA benchmark cap, and increasing flexibility to offer coverage using Value-Based Insurance Design.

Statement for the Record: Ways & Means Committee MA Hearing on Promoting Integrated and Coordinated Care for Medicare Beneficiaries, June 2017

Telehealth in Medicare

ACHP members increasingly utilize telehealth to expand access, provide clinical care and strengthen coordination of services. Health plans are using electronic visits, video technology, and remote monitoring to provide care as well as diagnose and treat when appropriate.

Statutory and regulatory restrictions currently inhibit the use of these technologies in both the traditional Medicare program and in Medicare Advantage. ACHP believes that telehealth technologies should be considered a complementary means of providing clinical services, and not a service itself. That’s why ACHP is working to enact legislation that would allow Medicare Advantage plans to utilize the full range of remote technologies to care for beneficiaries.

ACHP Recommendations to CMS for Regulations Implementing Telehealth Provisions of the Bipartisan Budget Act, July 2018
National Coalition of Health Care Letter to Congressional Leaders on Extenders Package, February 2018
Letter to Congressional Leaders on the Extenders Package, February 2018

Additional Medicare Advantage efforts

ACHP response to CMS proposal to lower drug prices and reduce out-of-pocket expenses in Part D and Medicare Advantage, January 2019
Letter to Congressional Leaders on the Lame Duck Session, November 2018
Letter to CMS Administrator Seema Verma on Deeming, October 2018
Letter to Senate Finance Committee regarding CHRONIC Care Act, May 2017