On January 25, the Centers for Medicare and Medicaid Services (CMS) published a Request for Information (RFI) on increasing transparency and data capabilities within the Medicare Advantage (MA) program. The RFI has an extended comment period of 120 days to ensure broad stakeholder feedback.
MA plans now constitute over 50% of Medicare enrollment and the federal government is projected to allocate $7 trillion to MA health insurance companies over the next decade. Transparency is critical to enhancing market competition and ensuring prudent allocation of Medicare funds to provide top-tier healthcare.
The RFI topics are incredibly broad, seeking data-related input on all aspects of the MA program, including:
- Access to Care
- Prior Authorization
- Provider directories and networks
- Supplemental benefits
- Marketing
- Care quality and outcomes
- Value-based care arrangements and equity
- Health competition in the market (including the effects of vertical integration and impact on payment)
- Suggestions for improving MA data collection and release methods
ADVOCATE, through our industry trade group, the Healthcare Business Management Association (HBMA) Government Relations Committee is reviewing the RFI and intends to submit a response to CMS.
ADVOCATE will share additional information with clients and friends as it becomes available on this and other Federal Health Policies.
Kirk Reinitz, President
