Press Release

RELEASE — ACHP Calls on Lawmakers to Reward Quality in Medicare Advantage

Restoring Benefits to Seniors Opens Doors for Innovation in Health Care

Washington (April 25, 2018) – The Alliance of Community Health Plans (ACHP) urges lawmakers to address a glitch in the Medicare Advantage quality payment program to address barriers to innovation in health care. ACHP submitted a statement to the House Ways and Means Subcommittee on Health ahead of tomorrow’s hearing on Identifying Innovative Practices and Technology in Health Care.

“Seniors risk being shortchanged an estimated $821 million in increased services and reduced premiums this year because many health plans are not receiving promised quality incentive bonuses,” said ACHP President and CEO Ceci Connolly. “This is an unintended consequence that diminishes benefits to seniors, undermines value-based care and discourages the sort of innovation that leads to high- quality coverage and care.”

Policymakers designed MA to reward superior performance with bonus payments based on a plan’s quality, patient satisfaction and regulatory compliance. However, due to a glitch in how the bonus is calculated, some of the highest-quality MA plans have not received their full incentive payments. ACHP plans use their hard-earned quality bonuses to offer dental, hearing and vision services and to trim monthly premiums. Since every dollar awarded must be returned to seniors in the form of reduced premiums or increased benefits, enrollees are the ones losing out.

“We thank Congress for its leadership in addressing the important issue of barriers to innovation in health care,” said Connolly. “ACHP and our members are focused on quality care and are committed to working with the administration and Congress to enhance benefits for seniors.”

ACHP member organizations account for half of the top-scoring, or 5-Star, MA plans nationwide. They excel at managing chronic conditions, enhancing communication with care teams and increasing preventive screenings. ACHP plans provide coverage and care to more than 20 million Americans, including nearly 2.5 million MA beneficiaries.

To access the full text of the ACHP letter, click here.

About ACHP
The Alliance of Community Health Plans (ACHP) is a national leadership organization bringing together innovative health plans and provider groups that are among America’s best at delivering affordable, high-quality coverage and care. ACHP’s member health plans provide coverage and care for more than 20 million Americans across 32 states and the District of Columbia. These organizations focus on improving the health of the communities they serve and are on the leading edge of innovations in affordability and quality of care, including primary care redesign, payment reform, accountable health care delivery and use of information technology. To learn more, go to www.achp.org and follow ACHP on Twitter @_ACHP.