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New Study Gives Medicare Advantage Edge in Quality of Care

Medicare Advantage is the best bet for seniors looking at their options as the open enrollment period begins, according to a new study published by the “Journal of the American Medical Association (JAMA) Health Forum.”

Medicare Advantage, also known as Medicare Part C, gives seniors a choice about how to get their medical services delivered over the traditional fee-for-service Medicare plan. According to the JAMA study, that choice also gives seniors better value and better care.

Examining data from nearly two million Medicare beneficiaries, the JAMA-published study concluded that “those enrolled in MA had lower rates of hospital stays, emergency department visits, and 30-day readmissions.” Additionally, the study noted that “[a]mong Medicare beneficiaries with complex care needs, those enrolled in MA had lower rates of acute care utilization, suggesting that managed care activities in MA may influence the nature and quality of care provided to these beneficiaries.”

Medicare Advantage provides health care plans offered by approved private coverage providers. Unlike government-run fee-for-service Medicare, Medicare Advantage plans can cover additional services that seniors rely on and depend upon, such as prescription drugs and routine eye and dental care.

The option currently enjoys broad bipartisan support in Washington, with all four members of New Hampshire’s federal delegation calling for more support for Medicare Advantage earlier this year. Sen. Maggie Hassan was part of a group of 62 lawmakers who signed off on a letter supporting the program.

“We write to express bipartisan support for the Medicare Advantage program and the high-quality, affordable care it provides to over 27 million older adults and people with disabilities,” the letter read, signed by members as ideologically diverse as Sens. Mazie Hirono (D-Hawaii) and Tommy Tuberville (R-Ala.)

In September, both Reps. Annie Kuster and Chris Pappas joined the House of Representatives in passing a bill on a voice vote to make it easier for seniors using MA to get approval for treatment and prescriptions.

Traditional fee-for-service Medicare does not limit seniors’ out-of-pocket costs and copays. As a result, beneficiaries pay nearly $2,000 more per year in total healthcare-related costs than those enrolled in Medicare Advantage plans.

Because Medicare Advantage relies on the private sector, some more progressive politicians oppose the option and have tried to limit its expansion or even kill it entirely. The progressive magazine “The American Prospect” wrote about Medicare advantage, and their opposition to it, in a piece headlined “The Dark History of Medicare Privatization.”

Last week, Hassan, Pappas, Kuster, and Sen. Jeanne Shaheen signed a letter urging the Centers for Medicare and Medicaid (CMS) to protect eligible New Hampshire Medicare beneficiaries subject to aggressive and potentially predatory marketing tactics related to the sale of Medicare Advantage (MA) plans or other insurance products.

However, based on the data, it appears seniors are satisfied with both the coverage and the quality of care received.

According to the non-partisan Kaiser Family Foundation, Medicare Advantage enrollment has doubled over the last 15 years. Currently, 32 percent of Medicare-eligible Granite State seniors choose Medicare Advantage over traditional fee-for-service Medicare.

Reports from the Better Medicare Alliance, a research and advocacy group, indicate 95 percent of Medicare Advantage beneficiaries are satisfied with their network of care and a full 88 percent say Medicare Advantage gives them more flexibility and choice.

A separate study published by JAMA found Medicare Advantage beneficiaries received 9.2 percent fewer “costly, potentially harmful” low-value services than fee-for-service Medicare enrollees. In other words, Medicare Advantage beneficiaries received better-quality care.


Congress Should Side with Seniors on Prescription Drug Costs

Anyone who wants to be the next president needs to protect seniors, not drug company profits.

 Congress did a good thing earlier this year when it passed a law to help America’s seniors pay less for their prescription drugs. But now, big drug companies are spending millions trying to strong-arm members of Congress into breaking the deal just to boost their own profits.

This would be a terrible blow to seniors. Over 40 million older Americans rely on the Medicare Part D prescription drug benefit to help them pay for life-saving medicines. Unfortunately, an increasing number of them have to decide between putting food on the table and filling their prescriptions.

Consider this: AARP’s Public Policy Institute found that the average annual retail price for widely-used brand name prescription drugs was nearly $6,800 in 2017. For the average older American who takes 4.5 brand name prescription drugs on a chronic basis, their annual cost of therapy would have been more than $30,000—over 20 percent higher than the median annual income for Medicare beneficiaries.

In a 2015 AARP survey of the 50+ in New Hampshire, 85% said that affording health care/prescription drugs was extremely or very important to them.  What’s more, nearly half (48%) said they worry about being able to afford their prescription drugs.

The law passed earlier this year required drug manufacturers to provide a bigger discount on their brand name drugs for the Medicare beneficiaries who are in the Part D donut hole. This critical reform, if allowed to continue, would save seniors an estimated $6.7 billion between 2020 and 2027.

PhRMA wants Congress to roll back this year’s Part D deal, which would deliver $4 billion more in profits to pharmaceutical companies over 10 years. The industry is the last one that needs to make more money off of seniors and taxpayers. In 2016 alone, Medicare Part D paid $141 billion to drug companies.

These same big drug companies who reap tens of billions of dollars annually from Medicare Part D are trying to get Congress to reverse the savings it delivered to seniors earlier this year. These companies are spending millions on advertising and lobbying targeting Congress. What a waste!  Those millions could be devoted to developing drugs to treat diseases such as Alzheimer’s and Parkinson’s.

And there’s an ironic disconnect.  President Trump has been talking a lot lately about how unfair it is that Americans pay the highest drug prices in the world. But just months after Congress made progress toward lowering drug costs, some members of Congress are preparing to side with the drug lobby rather than look after their own constituents’ interests, which align with the President’s position.

A deal is a deal.  AARP’s 230,000 members in New Hampshire are not going to sit by and let this happen.

Senators and others who want to be President, take note. When you come to our community, be prepared to show that you have what it takes to stand up to big drug companies. Older Americans vote – a majority of voters in the 2018 election were over 50 – and they will remember whether presidential candidates stand by seniors or sided with big drug companies to raise the cost of prescription