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What Providers Have To Say About Medicare Advantage

posted by Alicia Caramenico

on January 20, 2015

You’ve seen the benefits of Medicare Advantage from the patient perspective. Here’s what providers are saying about the important program that roughly 16 million seniors rely on for superior care.

– Providers praise Medicare Advantage for improving patient outcomes

As Dr. Tyler Jung, chief medical officer for DaVita HealthCare Partners, said in his recent op-ed in The Hill, Medicare Advantage program is what enables DaVita HealthCare Partners to coordinate high-quality, comprehensive care and meet patients’ individual needs. And those efforts are achieving measurable results: 16.1 percent of DaVita HealthCare Partners senior patients are readmitted to the hospital within 30 days of discharge, compared to 18.5 percent of Medicare fee-for-service patients. The results in California also speak to the success of Medicare Advantage, where DaVita readmissions for HealthCare Partners seniors totaled 14.2 percent last year.

Members of the U.S. House GOP Doctors Caucus have shared similar statistics as they stand up for the Medicare Advantage program. “In MA, medical professionals deliver higher quality care using tools that enhance patient-provider communications, reducing hospitalizations by over 20 percent and individual patient health care costs by over $10,000 each year,” they wrote in a letter earlier this spring to the Centers for Medicare & Medicaid Services. “Through heightened collaboration, providers identify treatment gaps and deliver needed follow-up care to MA beneficiaries, decreasing emergency department visits by 20 to 30 percent.”

– They support the Medicare Advantage approach to team-based care

Dr. Amy Nguyen, CMO of CAPG, applauded the team-based model available through Medicare Advantage, which helps to prevent potential gaps in care for seniors. Dr. Nguyen was joined at last week’s Capitol Hill briefing by Dr. Erik Steele of Summa Health System who noted that with team-based care, Medicare Advantage reduces patient misery. He added, “You cannot take care of complex patients without a team-based approach,” one of the many benefits afforded by Medicare Advantage coverage.

Medicare Advantage coverage and its team-based, coordinated, culturally competent care is critical to minority and low-income communities, Dr. Elena Rios, president and CEO of the National Hispanic Medical Association, said at the briefing. She noted that 40 percent of the Hispanic Medicare population has chosen Medicare Advantage.

– Providers warn that cuts are dangerous

Despite the program’s popularity, Medicare Advantage faces major payment cuts that would threaten the lower costs, higher quality and better access that seniors depend on. Seniors already are feeling the effects of existing cuts to Medicare Advantage, making the consequences for beneficiaries even more concerning, Dr. Kavita Patel, a physician and policy expert with the Brookings Institution, wrote in The Hill earlier this year. Cuts to program will hit beneficiaries as higher out-of-pocket-costs, limited access to providers, and reduced benefits, she said.