On May 9, CMS Administrator Seema Verma delivered a speech at the Medicare Advantage and Prescription Drug Plan Spring Conference. Her prepared remarks for delivery highlight CMS’ current thoughts and strategies related to Medicare Advantage as she highlighted several items that CMS is undertaking to support Medicare Advantage, Part D and to empower beneficiaries.
CMS has made several changes to the Medicare Open Enrollment portal including launching a Coverage Wizard to help beneficiaries learn about their coverage options and make and informed choice between original Medicare and Medicare Advantage. CMS has made changes to the Medicare handbook “to clearly highlight the benefits of joining a Medicare Advantage plan, such as protection from high out of pocket expenses and access to important additional benefits.”
For the upcoming enrollment period, CMS will offer the following new tools and features to help Medicare beneficiaries make their decision:
- Stand-alone out-of-pocket cost calculator with information on overall costs and specific prescription drugs.
- Improved coverage wizard which will integrate with out-of-pocket costs to help consumers compare options at a deeper level including costs.
- Simplified log-in for the Medicare Plan Finder tool
- A piloted webchat option for a portion of users within the Medicare Plan Finder
- An updated Medicare handbook that includes check lists and flow charts to simplify decision making.
Administrator Verma went on to say that “it is critical that we unleash the potential of Medicare Advantage and Part D, so we at CMS have been listening to providers, plans and stakeholders about their experiences in the program.” As a result, CMS has made changes for 2019 to allow Medicare beneficiaries access for the first time ever to additional benefits. “These plans can offer benefits that compensate for physical impairments, diminish the impact of injuries or health conditions, or reduce avoidable emergency room utilization. This means Medicare Advantage beneficiaries will be provided adult day care services, respite care for caregivers, and in-home assistance with activities like dressing bathing and managing medications. Additionally, Medicare Advantage beneficiaries will have access to safety devices to better prevent injury in the home, including stair rails, grab bars, and temporary mobility ramps.”
Toward the end of the speech, Administrator Verma discussed data driven patient care and the desire for additional transparency related to Medicare Advantage plans and CMS’ new plans to release Medicare Advantage encounter data to researchers for the first time. CMS is also considering rulemaking to require Medicare Advantage to adopt data release platforms.
This speech elaborates on the 2019 Final Call Letter highlighted in the last edition of the Communique. It clearly states the types of services the CMS envisions from the change in policy that they have made for Medicare Advantage plans related to supplemental health benefits and the new role that LTSS benefits may have in those plans. It is still unclear whether those new benefits will be ready for the 2019 plan year, but CMS clearly anticipates their delivery in the coming years. This change could have a large impact on consumer decision-making toward Medicare Advantage in the future.