Washington, D.C. (April 26, 2022) – The Alliance of Community Health Plans (ACHP) applauds the Senate 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.
“Last 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 Senators Daines (R-MT), King (I-ME), Scott (R-SC) and Smith (D-MN) 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—driving value in the Medicare Advantage program and enhancing 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 reduced prescription drug costs, nutrition support, dental and hearing services, and diabetes management.
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 Medicare Advantage plans to deliver the best quality possible, boosts the value of top Medicare Advantage 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 one third of the top-scoring, or 5-Star, Medicare Advantage plans nationwide. They are leaders at managing chronic conditions, enhancing communication with care teams and increasing preventive screenings. Nearly all ACHP Medicare Advantage enrollees—more than 95 percent—are in a four-star plan or higher.
The Alliance of Community Health Plans (ACHP) represents the nation’s top-performing nonprofit health plans to improve affordability and outcomes in the health care system. 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.