Perspective from Alan Sager, PhD
October 06, 2017
2 min read

ACP: Increased Medicare Advantage transparency will reduce burdens, confusion

Perspective from Alan Sager, PhD
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In a new policy paper, the American College of Physicians encouraged Medicare Advantage to increase transparency and better align plans to diminish excessive and burdensome administrative tasks on clinicians, as well as confusion among patients.

“As enrollment in Medicare Advantage [MA] plans increases, there is a growing interest in understanding the differences in care delivery, quality, resource utilization and cost between MA and traditional Medicare,” Jack Ende, MD, MACP, president of American College of Physicians (ACP), said in a press release. “If MA plans were to increase transparency, that would give the Centers for Medicare and Medicaid Services the opportunity to examine them more closely and promote alignment, thus lessening the administrative burden associated with clinician participation in these plans.”

In the paper, ACP offered three recommendations to address concerns with the MA program, namely physician burdens and patient confusion. First, ACP highlighted its support of policies that guarantee funding of MA plans at the traditional Medicare program level and recommended that at least 85% of the funding go to beneficiary care.

In addition, ACP called for more transparency in the processes, policies and procedures that Medicare Advantage Organizations (MAOs) implement to develop and administer MA plans and portfolios. Collaboration with relevant stakeholders is essential in streamlining and aligning policies, procedures and contracting arrangements with physicians, according to ACP.

Lastly, ACP emphasized the need for further research on how MAOs utilize federal payments to the MA program, such as research comparing the types of payment models used and the prices paid to contracted physicians, hospitals and other clinicians of MAOs with traditional Medicare and commercial health insurance plans.

“As Medicare moves away from its traditional fee-for-service and toward the Quality Payment Program linking physician payment to high-value care, it is a critical time for the MA program to make improvements,” Ende concluded. “The relief from administrative burdens that our recommendations would provide to clinicians is an important component of promoting high-value care for all Medicare beneficiaries.”