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AHIP Responds To CMS Request For Information Following Final Medicare Rate Notice

posted by Cathryn Donaldson

on April 25, 2017

The Association requests additional transparency, support for innovation, and reduced complexities to strengthen Medicare Advantage for beneficiaries

WASHINGTON, D.C. –America’s Health Insurance Plans (AHIP) responded to the Centers for Medicare & Medicaid Services (CMS) request for information (RFI), following the final Medicare Advantage Rate Notice and Call Letter for the 2018 benefit year, released on April 3. CMS issued the RFI to help uncover transformational ideas that can be applied to the Medicare Advantage (MA) and Part D programs.  Through the response to the RFI, AHIP has recommended how health plans and CMS can work collaboratively to enhance flexibility, innovation, and efficiency of the MA and Part D programs.

Today, more than 18 million seniors – or 32 percent of all Medicare beneficiaries – rely on the MA program, with 16.6 million receiving drug benefits through their plan. Since 2010, MA enrollment has increased by 60 percent, while Part D enrollment has increased from 24 million in 2007 to over 42 million today.  Further, MA plans often offer additional benefits to beneficiaries for no additional premium, and 90 percent of beneficiaries have access to at least five MA plans.

“We commend CMS for their interest in sourcing the best solutions on behalf of MA beneficiaries, and inspiring innovation from our health plans and the private sector through this RFI,” said Marilyn Tavenner, AHIP President and CEO. “Working together, we’ve achieved many successes in the Medicare Advantage and Part D programs, and we look forward to further enhancing care delivery, driving down costs, and improving outcomes.”

The AHIP RFI proposal recommends changes that will promote stability, innovation, and high-quality care for beneficiaries, through:

  • Improved transparency and predictability through collaborative communication. More proactive and transparent communication from the Agency will strengthen quality programs, such as the Star Ratings Program, and enable health plans to work collaboratively with CMS to ensure the best possible coverage for beneficiaries delivered in the most cost effective way possible.
  • Enhanced beneficiary experience and choice. The use of telehealth services, improvements to the Medicare Plan Finder, innovative changes to the MA program and enrollment process, and other improvements allowing for increased plan flexibilities will lead to an overall better customer experience – from the plan they select to the health care they receive.
  • Reduced program complexity and regulatory burden. Limiting regulatory and sub-regulatory burdens, data collection, and reporting requirements, will increase plans’ ability to be nimble and streamline information and benefits for beneficiaries.

The CMS RFI demonstrates a clear commitment from the Agency to work in tandem with health insurers and other health industry leaders to improve already strong and stable programs, and further support Medicare beneficiaries through better care, better outcomes and lower costs. The full RFI and cover letter to CMS Administrator, Seema Verma, can be found below.