LeadingAge Releases Report on the Failures of Medicare Advantage in Post-Acute Services

LeadingAge Releases Report on the Failures of Medicare Advantage in Post-Acute Services

LeadingAge recently released a report, “Fulfilling the Promise: Medicare Advantage”, describing problems and policy recommendations for Medicare Advantage in long term care. According to the report, “one in five Medicare beneficiaries discharged from a hospital will need post-acute care. Those with Medicare Advantage plans may run into significant challenges in trying to access post-acute care.”

ATI Advisory CEO, and Nexus Fellow, Anne Tumlinson, told McKnight’s Senior Living that “[i]t’s simply a matter of Medicare Advantage plans waking up to the opportunity to design plan products that offer supplemental benefits and quality improvement programming — as well as value-based contracts with in-house primary care organizations — to reduce the cost of senior living services to the residents, and to offer a higher-value, more comprehensive aging-in-place option.”

The LeadingAge report includes recommendations such as:

  • Make payment rates adequate and predictable.
  • Understand and address challenges with prior authorization.
  • Bring the vision of high-quality care closure to routine practice by making value-based payments workable.
  • Ensure beneficiaries have a true choice of high-quality providers by addressing MA plan network adequacy.
  • Address transparency concerns by improving data collection and sharing.
  • Actively support beneficiaries’ needs and rights.

Tumlinson said that “[i]f policymakers are looking for a road map to improve Medicare Advantage for populations with complex care needs, LeadingAge’s recommendations provide an excellent one.”

Read the full story at McKnight’s Senior Living.
Read the LeadingAge report on Medicare Advantage.


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