In a conversation with MedPageToday the chair of the Medicare Payment Advisory Commission (MedPAC) gave a list of things Medicare Advantage (MA) could do better. I’m encapsulating and quoting this article 10 Ways MedPAC Commissioners Think Regulators Should Fix Medicare Advantage Plans from MedPageToday written by Cheryl Clark. I encourage you to read the original article for more detail.
Commissioners want the agency to address:
1. Pave a way for unhappy MA enrollees with "reasonable buyer's remorse" to leave their MA plans …
2. Require MA plans to maintain up-to-date directories of providers, …
3. Study Medicare's rules for assuring that MA plan enrollees can get in-network coverage …
4. Mandate that beneficiaries have a reliable way to compare plans ..
5. Prohibit plans from restricting first-choice access…
6. Require that each plan disclose on the Medicare Plan Finder whether it allows enrollees to get care at comprehensive or National Cancer Institute-designated cancer centers in network -- or with discounted co-pays at out-of-network facilities -- and to specify which ones. …
7. Revamp MA plan star ratings metrics to reflect the stability and consistency of a plan's provider network in a way that would include each plan's prior authorization denial rate, and indicate how much enrollees can rely on their providers staying in-network. …
8. Find ways to make sure beneficiaries know what they are giving up when they enroll in an MA plan with respect to being constrained to narrow provider networks and accepting delays or denials of care because of prior authorization.
9. Require that MA plans list behavioral health plans in their directories by provider name…
10. Improve the user-friendliness of the appeals process ...
As I’ve stated before, I personally believe that privatizing Medicare is a step in the wrong direction. Even if all those MA issues above were fixed, I’d rather have Medicare for all and stop subsidizing private health insurance industry. The chair of the MedPAC says it will take years for a formal report to be sent to Congress and implemented, so in the meantime more people will be facing serious issues. I feel like it’s important to raise awareness for those who still have a choice.