Families USA Statement for the Record for Ways and Means Health and Oversight Subcommittee Hearing On Medicare Advantage

Families USA submitted a statement to the Ways and Means Health and Oversight Subcommittees thanking committee members for holding a timely hearing and stressing the importance of reform in the Medicare Advantage (MA) program. As enrollment in MA continues to rise to its highest ever numbers, it is increasingly obvious that the program is not living up to its promise to provide comprehensive, high-quality coverage. For too long distortions in the MA payment system have allowed deceptive and predatory business practices that have drive low-value care for patients, as well as wasteful spending for the federal government.

In the statement, we urge Congress to take up the following actions to promote transparency, rein in wasteful spending and curb harmful insurer practices:

1. Strengthen the risk adjustment system by passing coding reforms such as those drafted in the No UPCODE Act, to prevent MA insurers from inflate their Medicare payments without providing additional care or coverage.
2. Improve the MA benchmark and bid system to promote healthy competition between MA and Traditional Medicare (TM) so MA insurers are only financially rewarded for bidding below their true costs.
3. Hold MA insurers accountable to delivering high quality care and coverage by strengthening the quality bonus payment program — setting higher absolute performance targets that are not based on average plan performance and rewarding incremental progress toward targets.
4. Promote meaningful transparency by requiring MA insurers to submit high quality and complete encounter data to CMS, so lawmakers and the public fully understand how the MA program is fulfilling their obligations to deliver affordable and high-quality care.
5. Invest in improvements to Traditional Medicare such as adding a standard dental, vision and hearing benefit as key steps toward meaningful competition between MA and TM.

Families USA appreciates these subcommittee’s focus on this critical issue and looks forward to working with all of its members to improve affordable and accessible health care for our nation’s seniors.