Month: October 2016

Improved quality of Medicare health and drug plans means great news for Medicare beneficiaries

Improved quality of Medicare health and drug plans means great news for Medicare beneficiaries

by Sean Cavanaugh, Deputy Administrator and Director of the Center for Medicare As we get further into the fall season, the Centers for Medicare & Medicaid Services (CMS) is preparing for the annual Medicare Open Enrollment, which begins on October 15 and ends on December 7. For the 2017 plan year, Medicare Advantage and the Medicare Prescription Drug Plans continue to provide high-quality options for people with Medicare. Recently, I wrote about how the Affordable Care Act has strengthened Medicare health and drug plans. In 2017, enrollment in Medicare Advantage is expected to reach an all-time high of about 18.5 million, a 60 percent increase from 2010, the year the Affordable Care Act was passed. About one-third of all Medicare enrollees will be in a Medicare Advantage plan in 2017. And enrollees in Medicare health and drug plans are receiving better care as a result of the Affordable Care Act, which provides bonuses to higher quality plans (i.e., those with four or five stars on a five-star scale).  In 2009, only about 17 percent of Medicare Advantage enrollees were in four and five star plans; for 2017, 68 percent of enrollees are in four and five star plans. Medicare Prescription Drug Program enrollees are also benefiting from quality improvement among plans, with about 41 percent of prescription drug plan enrollees in plans with four or more stars for 2017, compared to 27 percent of enrollees in such plans in 2009. For people with Medicare, this is good news. Plans that are rated higher deliver a higher level of care, such as improving the coordination of care, helping enrollees to manage diabetes or other chronic conditions more efficiently, screening for and preventing illnesses, or making sure people get much-needed prescription drugs. A high rating also means that these plans give better customer service, with fewer complaints or long waits for care. CMS is continuing to strengthen Medicare Advantage and the Prescription Drug Programs so that they continue to provide high-quality affordable accessible care for current and future Medicare beneficiaries. To learn more about the Star Ratings in Medicare Advantage and the Prescription Drug Program, please visit: http://go.cms.gov/partcanddstarratings. People with Medicare can use the Medicare Plan Finder online tool available at www.Medicare.gov to search for plans available in their area and compare plan quality, costs, and coverage.

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Tackling Tough Issues Together: The CMS Rural Health Council Solution Summit

By Cara James, Director of CMS Office of Minority Health and John Hammarlund, Regional Administrator 

In 1909, President Theodore Roosevelt’s Country Life Commission issued a report finding that in rural populations, “the physicians are further apart and are called in later in cases of sickness, and in some districts, medical attendance is relatively more expensive.” We have made progress in closing some of the access gap in recent years. Since the Affordable Care Act was signed into law by President Obama in 2010, uninsured rates in rural America have dropped by nearly 40 percent with corresponding improvements in access to care. Nevertheless, rural Americans are more likely to live in states that have not expanded Medicaid, more likely to live in areas with fewer physicians per capita, and more likely to have difficulty accessing timely emergency care.

To address these issues, earlier this year CMS established the CMS Rural Health Council. Made up of experts from across the agency, the Rural Health Council has been thinking about three strategic areas – first, ways to improve access to care for all Americans in rural settings; second, ways to support the unique economics of providing health care in rural America; and third, making sure the health care innovation agenda appropriately fits rural health care markets.

Supported by the Council, CMS has undertaken a number of efforts to reach out to stakeholders to hear about ways to improve access to services for rural Americans. CMS has rural health coordinators at each of our Regional Offices, who meet monthly with the Health Resources and Services Administration (HRSA) to discuss emerging issues. During the Rural Health Open Door Forums, CMS engages with stakeholders to provide current information on CMS programs, answer questions, and learn about emerging rural health issues.

Through our rural health coordinators and the Rural Health Council, CMS has conducted nearly two dozen listening engagements nationwide on key rural health issues, such as telemedicine, hospice, and hospital support. We’ve heard directly from physicians and hospitals who are treating their patients while juggling the unique challenges of rural health care.

In recent years, CMS reformed Medicare regulations that were identified as obsolete or excessively burdensome on hospitals and rural health care providers, which will save providers nearly $660 million annually and $3.2 billion over five years.

Going forward, we’re continuing to embed a rural focus into new programs. For example, with the proposed new Quality Payment Program, we’re making a special effort to reach clinicians in rural areas. Through technical assistance and other activities, we’ll help them transition to the proposed Quality Payment Program’s new approach for paying clinicians for the value and quality of care they provide.

We hope that all of our ongoing efforts, including the work of the CMS Rural Health Council, will give us a better understanding of how our policies and programs affect rural communities.

But we can’t address the challenges of rural communities alone. That’s why we recently announced we will be conducting the CMS Rural Health Solutions Summit on October 19, 2016, at CMS headquarters in Baltimore, Maryland. The CMS Rural Health Council will be bringing in stakeholders from all sectors of the health care industry as we engage in in-depth discussions about ways to improve access to care in rural America and support local innovation in care delivery. We’re excited to bring together national, state, and local leaders to discuss innovative strategies for improving rural care, access, and cost. This discussion will help us work together towards rural health policy and implementation that drives high-value, high-quality health care. If you’d like to join our conversation on October 19, please register at https://register.mitre.org/CMS_Rural_Health_Solutions_Summit/index.html

 


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