From reforming the Star Ratings program intended to steer consumers to the highest-quality plans to reducing gaming of the current risk adjustment system used to set insurer payments, the Alliance of Community Health Plans (ACHP) is envisioning the future of Medicare Advantage with MA for Tomorrow. While the new framework, released last month, comes at a time when the Star Ratings and other aspects of the MA program are under intense scrutiny, ACHP tells AIS Health, a division of MMIT, that it is the result of a multiyear collaboration with subject matter experts at its provider-aligned, not-for-profit health plans.
ACHP provides recommendations around five key pillars: raising the bar on quality, improving consumer navigation, advancing risk adjustment for care not coding, modernizing network composition and transforming benchmarks. And it says many of the provisions contained in these pillars can be implemented right away. AIS Health spoke with ACHP’s president and CEO, Ceci Connolly, and associate vice president for public policy, Michael Bagel, to learn more about the specific recommendations. (Editor’s note: This interview has been edited for length and clarity.)