August 3, 2021
Washington, D.C. – The Alliance of Community Health Plans (ACHP) applauds the House for prioritizing value-based care and taking steps to address a glitch in the Medicare Advantage quality payment program. The Medicare Advantage Quality Payment Relief Act proposes a simple policy fix that would benefit seniors and reward health plans for delivering the highest quality care.
“This year, more than 5.7 million seniors missed out on approximately $230 million in additional services and/or reduced premiums due to the payment glitch,” said ACHP President and CEO Ceci Connolly. “We thank Reps. Ron Kind (D-WI), Mike Kelly (R-PA), Mike Doyle (D-PA) and Brett Guthrie (R-KY) for their leadership on this issue. This small fix will ensure that the highest quality Medicare Advantage plans are even better able to serve their members — leading to enhanced care for millions of America’s seniors.”
Quality bonus payments in Medicare Advantage, which must be returned as benefits to enrollees, are subject to a payment cap. If corrected, ACHP member plans would be able to offer additional or enhanced benefits such as enhanced dental coverage, reduced prescription drug costs and addressing social determinants of health. One ACHP member, Security Health Plan, part of the Marshfield Clinic in Wisconsin, could reduce its monthly Medicare Advantage premium on average by $15 per month.
The bill, which has broad bipartisan support, would restore full quality payments to the highest performing 4- and 5-star health plans. The bill is critical to ensuring value in the Medicare Advantage program.
“ACHP and our members are committed to making high-quality coverage and care accessible. This legislation encourages MA plans to deliver the best quality possible, boosts the value of top MA plans and provides enhanced benefits for millions of Americans across the country,” said Connolly. “We look forward to working with the Administration and Congress on ensuring seniors have access to the highest quality care possible.”
ACHP member organizations account for 43% of the top-scoring, or 5-Star, MA plans nationwide. They are leaders at managing chronic conditions, enhancing communication with care teams and increasing preventive screenings. Nearly all ACHP MA enrollees—more than 93%—are in a four-star plan or higher. ACHP plans provide coverage and care to more than 23 million Americans across 36 states and the District of Columbia.
The Alliance of Community Health Plans (ACHP) represents the nation’s top-performing non-profit health plans to improve affordability and outcomes in the health care system. ACHP member companies serve more than 23 million Americans in 36 states and the District of Columbia. Members are provider-aligned health organizations that provide high-quality coverage and care to tens of millions of Americans. They are leading the industry in practical, proven reforms around primary care delivery, value-based payment and data-driven systems improvement. Learn more at the ACHP website and follow us on Twitter for the latest health insights.