From 3M Health Information Systems
Think bipartisanship is dead? Two words – Medicare Advantage
Now that the masses have returned home from either the inauguration or protests in our nation’s capital, the Legislative and Executive branches have begun the daily scrum of governing. Given the polarized state of our politics there will be precious few issues on which both parties will likely find common ground, save perhaps one – Medicare Advantage (MA). That’s right. Of all the weighty geopolitical and domestic concerns begging for consensus, little ol’ Medicare Part C has the best chance of actually achieving it. Why, you ask? Because each group gets much of what it wants.
Republicans like Medicare Advantage, because it introduces market forces into what they view as a government monopoly and provides beneficiaries freedom of choice. Medicare vetted and regulated private insurers offer comprehensive coverage which equals or exceeds Original Medicare, often for little or no monthly premium. From a budgetary standpoint the GOP also likes the fact that Medicare Advantage essentially caps the cost of Medicare spending for participating beneficiaries and places the insurers at risk for managing patient care.
Democrats like Medicare Advantage because its advent created a huge national laboratory in which numerous managed care and population health experiments can be conducted and studied. To date, Medicare Advantage has been the most successful, large-scale value-based care initiative in health care. To be fair, many Democrats were initially suspect of Medicare Advantage and felt it gave an unfair edge to participating health plans. However, as the program grew in popularity and enrollment, left-leaning policy makers recognized the powerful voting block that emerged as a result.
Make no mistake, the Elephants and Donkeys like MA for very different reasons, but isn’t that how good legislation should work? Neither side gets everything it wants, but both sides get pieces that are important to them. And don’t forget the other key stakeholders in this discussion – providers, insurers and, most importantly, beneficiaries.
Providers like MA because they can focus more on practicing medicine and less on making sure they’re up to date with myriad and constantly changing quality measures. Insurers prefer the program because the revenue stream is substantial, reliable and allows health plans to focus on what they do best – build networks and manage care. And those on Medicare have voted with their feet, because they like an alternative cost-sharing structure to Original Medicare and the extras that MA often covers like dental, vision and health club memberships. Original Medicare covers none of those services.
It looks as though political leaders of both stripes will continue digging in their heels on most of the issues facing our nation. Medicare Advantage, however, looks to be a model for American ingenuity and consensus going forward.
Clark Cameron is manager of payer market strategy and development for 3M Health Information Systems.