On Tuesday, the House Ways and Means Health Subcommittee held a hearing on the Medicare Advantage program’s plan operations, quality measurements and challenges faced by emerging insurers. The panel of witnesses that included academics and insurers generally supported the advances in the plan finder but recommended improving its user-interface to make it more intuitive for beneficiaries. The panel also supported the overall flexibility on the types of benefits that MA plans are able to offer, but noted that transportation and food security could be areas of improvement while cautioning against adding too much complexity that may confuse beneficiaries.

Other issues that were brought up at the hearing included making regional adjustments to the star-rating system so that urban and rural health systems are more appropriately rated. Independence Blue Cross senior vice president of senior markets Daphne Klauser noted that among the five counties that Independence operates in there is significant variation in utilization between Philadelphia and outlying areas, and the rating system should reflect how the hospitals operate. Similarly, Jack Hoadley from the Georgetown University Health Policy Institute noted that health systems should be compared within the same peer group to ensure that reward systems are fair while still able to identify performance issues.

The panel also discussed increased plan design individualization, including efforts to provide more value-based care. NAHU has long advocated for value-based insurance design (VBID) to allow greater flexibility for an MA plan to meet the needs of enrollees, particularly those who are chronically ill, by tailoring coordination and benefits to specific patient groups instead of the required uniform benefits. The panel was generally supportive of these efforts to increase plan flexibility and tailor individualized care and benefits for patients. However, the panel cautioned that too much individualization could lead to confusion for beneficiaries and CMS should closely monitor how much complexity it introduces into plan design.