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.”
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