The Better Medicare Alliance (BMA) is an American 501(c)(4) non-profit advocacy coalition that supports sustaining and improving Medicare Advantage, a private health insurance option available to Medicare beneficiaries.[1]

Issues

Rate setting

The BMA was one of the most prominent voices in the rate-setting process for MedIcare Advantage in 2015. The Centers for Medicare and Medicaid Services (CMS) proposed a 2016 average baseline rate decrease of 0.95% in February 2015. The BMA opposed this reduction with a campaign that included digital and print ads. The BMA was particularly concerned about how access to Medicare Advantage in rural areas might be affected. More than 300 members of Congress wrote to CMS to oppose the cuts. BMA released a study conducted by Milliman, an actuarial consultancy, that showed how previous rate reductions had increased annual out-of-pocket costs for the sickest patients by as much as $761 since 2012 and increased the number of counties without access to Medicare Advantage providers from 55 in 2012 to 211 in 2015. Speaking on this issue, Krista Drobac, BMA's then interim executive director said, “The more cuts there are, the more reduction there is in value.” After six weeks of debate, the CMS decided to increase baseline rates by an average of 1.25%.[2][3][4]

Fee-for-service

BMA supports deemphasizing Medicare's current fee-for-service model for paying providers. In an op-ed Allyson Schwartz wrote, "For most of the last 50 years, Medicare has paid providers on a fee-for-service basis, which means doctors and hospitals were paid each time a patient went to see them for any reason. While this made sense in an era of acute illnesses and infrequent visits, this system rewards quantity over quality care. To change this, we need to modernize the financing of health services to ensure better quality and reward value not volume of care. By shifting payment and delivery strategies, we can encourage primary care teams, incentivize care coordination and continuity of care, and require attention to providing care to people, over time."[5]

Leadership

President and CEO

Allyson Young Schwartz is a former member of the United States House of Representatives for Pennsylvania's 13th congressional district, where she served from 2005 to 2015. Schwartz was a leading voice on healthcare issues while in Congress and was a key supporter for the Affordable Care Act (ACA). She was an advocate of the ACA provision that prohibits health insurance companies from denying coverage to people with pre-existing conditions. She opposed several parts of the ACA such as the medical device tax and the Independent Payment Advisory Board. Medicare policy was an important part of Schwartz's congressional career. In 2012 and 2013 she introduced bills to repeal Medicare's highly criticized sustainable growth-rate formula for payments to doctors, supported moving away from fee-for-service in favor of rewarding quality care and cost cutting. Schwartz harshly opposed Medicare's controversial Two-Midnight Rule for hospital admissions. Schwartz has worked on health policy for much of her career. Her work in healthcare started when she became assistant director of the Philadelphia Health Services Department in 1972.[2][6][7]

Board members

Kenneth Thorpe

Kenneth E. Thorpe is the Robert W. Woodruff Professor of Health Policy at Emory University, the chair of the Department of Health Policy and Management in the Rollins School of Public Health, and a former deputy assistant secretary at the Department of Health and Human Services during the Clinton administration. He is also the executive director of the Partnership to Fight Chronic Disease and the Emory Institute for Advanced Policy Solutions.[8]

Elena Rios

Dr. Elena Rios is president and CEO of the National Hispanic Medical Association, (NHMA). She also leads of NHMA's National Hispanic Health Foundation affiliated with the Robert F. Wagner Graduate School of Public Service, New York University, which conducts education and research. In 2006, Dr. Rios was appointed to the Minority Alumni Hall of Fame of Stanford University and in 2007, was made a Fellow of the New York Academy of Medicine. Rios has held numerous other positions related to health policy.[9]

Members

Founding members of the coalition include: the Healthcare Leadership Council, Healthways, Humana, The Latino Coalition, The National Caucus and Center on Black Aging, the National Hispanic Medical Association, the National Association of Manufacturers, the National Retail Federation, the Population Health Alliance, UnitedHealth Group, and the U.S. Chamber of Commerce.[6][10]

References

  1. ↑ "Archived copy". Archived from the original on 2015-08-11. Retrieved 2015-08-05.{{cite web}}: CS1 maint: archived copy as title (link), bettermedicarealliance.org; retrieved August 4, 2015.
  2. 1 2 Herman, Bob (21 April 2015). "Allyson Schwartz named CEO of Medicare Advantage lobbying group". Modern Healthcare. United States. Retrieved 22 September 2015.
  3. ↑ King, Robert (6 April 2015). "Final push to halt Medicare Advantage cuts". The Examiner. Washington, District of Columbia.
  4. ↑ "Administration Urged to Spare Medicare Advantage From Deep Cuts". Congressional Quarterly HealthBeat. Washington, District of Columbia. 15 February 2015.
  5. ↑ Schwartz, Allyson (30 July 2015). "Medicare at 50: An anniversary worth celebrating". Miami Herald. Miami, Florida.
  6. 1 2 "Leading Health Insurer Plans to Leave Industry Trade Group". Congressional Quarterly HealthBeat. Washington, District of Columbia. 23 June 2015.
  7. ↑ Schwarz, Sam (5 June 2015). "Former Members Follow a Variety of Paths". CQ Weekly. Washington, District of Columbia.
  8. ↑ "Kenneth E. Thorpe - Biography". www.worldcongress.com.
  9. ↑ "National Hispanic Health Foundation Holds Its Los Angeles Awards Gala". Professional Services Close-Up. United States. 21 November 2015.
  10. ↑ "HealthCare Roundtable e-News". Archived from the original on 7 August 2015. Retrieved 5 August 2015.
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