Better Medicare Alliance

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.

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%.

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."

President and CEO
Allyson Young Schwartz is a former member of the United States House of Representatives for PA'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.

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.

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.

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.

2024 Medicare Advantage Proposed Changes and BMA Response
The Centers for Medicare & Medicaid Services (CMS) annually publishes an advance notice detailing prospective changes for the subsequent year. These announcements often lead to varying interpretations among insurers regarding the potential impact on Medicare Advantage. BMA's research suggests that the proposed alterations, including higher premium rates, reduced rebates, and restricted access to local healthcare providers, could potentially limit healthcare accessibility for senior citizens.

In response to CMS's introduction of a new risk adjustment model, BMA has actively engaged in dialogue with the Biden administration, advocating for a reevaluation of the proposed changes to Medicare Advantage for 2024. The organization emphasizes its commitment to preserving the integrity of Medicare Advantage benefits while striving to minimize out-of-pocket expenses for enrollees.