Congressman Scott Peters

Representing the 52nd District of California

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Don’t turn back clock on seniors’ healthcare

Mar 19, 2015
Op-Eds

Don’t turn back clock on seniors’ healthcare

It is no secret that Democrats and Republicans have not often agreed on health policy in recent years.

We are writing as a bipartisan team because there is a critical healthcare issue on which we — and a growing number of our colleagues — have found common ground.

That issue is Medicare Advantage, the part of Medicare that now serves more than 16 million seniors nationwide. More and more seniors every year are choosing to get their Medicare coverage through Medicare Advantage.

Indeed, last year, amid heated partisan debates on health policy, concern about seniors in Medicare Advantage spurred a rare bipartisan, bicameral outpouring. More than 260 members of Congress urged the Centers for Medicare and Medicaid Services (CMS) to keep Medicare Advantage payments stable. Despite this, Medicare Advantage rates were nonetheless cut by another 3 percent.

Last year’s cuts came on the heels of similar rate cuts in 2012, 2013 and 2014. Over the last two years alone, the cuts total 10 percent.

These have not been euphemistic “Washington” cuts — mere reductions in previously projected rates of growth. These have been real cuts — payments have been reduced year over year. Meanwhile healthcare costs have increased. When you combine three years of lower payments with three years of higher costs, the only possible outcome is pain for seniors.

It is all adding up and seniors are feeling it. We know, because our seniors tell us about the higher out-of-pocket costs and benefit reductions they have experienced. Some have even had to change doctors.

By now it is very well-known that Medicare Advantage is exceptionally popular among Medicare beneficiaries, who value the enhanced benefits and out-of-pocket protections. But it is not just seniors who are concerned about the cuts. A growing number of physicians and other healthcare providers are urging stable payment rates for Medicare Advantage. They recognize that fee-for-service medicine is the past not the future. These providers appreciate the opportunity to care for patients via a model that focuses on prevention, coordinated care and value. They don’t want to go back.

Advocates for minority health are also speaking out about the importance of Medicare Advantage to the diverse communities they serve. Even employers are getting on board, because they strongly believe Medicare Advantage enables them to provide the best and most affordable coverage to their retirees.

The unfortunate irony about all the cuts is that Medicare Advantage is clearly providing better, more affordable healthcare to our seniors while spurring the very innovations that virtually everyone agrees are needed in healthcare delivery. Medicare Advantage is outperforming fee-for-service Medicare on prevention, management of chronic conditions and coordination of care. It is also far ahead in measuring and rewarding the quality of care. Indeed, quality measurement and payment models that reward medical providers for value rather than volume are at the very core of Medicare Advantage. We all know this is where the healthcare system needs to go.

We are starting to see the results of these innovations. Seniors in Medicare Advantage are both more likely to receive preventive care and less likely to be subject to preventable hospitalizations. Those with chronic conditions are getting extra assistance that helps them avoid the emergency room and lengthy hospital stays.

Why would we ever want to turn back the clock on real improvements in care for American seniors?

Seniors’ healthcare is too important to play politics with.

Three straight years of real cuts is enough. For the sake of the seniors we represent and the better healthcare system we all want, it is time for CMS to use its authority to stabilize Medicare Advantage rates.

Paulsen has represented Minnesota’s 3rd Congressional District since 2009. He sits on the Ways and Means Committee. Peters has represented California’s 52nd Congressional District since 2013. He sits on the Armed Services and the Judiciary committees.