Consumer-Centric CMS Policies Pave Way For Medicare Advantage For All

HILTON HEAD ISLAND, S.C., Jan. 27, 2021 /PRNewswire/ -- With the presidential transition being completed, Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma resigned this month - a common practice as new appointees are designated. Patrick Phillips, CEO of Cavulus, a leading technology provider in the Medicare Advantage (MA) industry, says the past four years created a roadmap of consumer-centric CMS policies that pave the way for expansion of the program to America's uninsured.

CMS was active in every aspect of the healthcare ecosystem throughout this past administration's tenure. It's apparent that competition and ultimately, consumer benefit, were the primary focus.

Since 2017, Phillips says "average Medicare Advantage premiums have dropped over 30%, yet the program produces significantly better outcomes than traditional Medicare". He cites recent analysis from The Better Medicare Alliance that demonstrates the merits of Medicare Advantage over traditional Medicare such as a 57% lower rate of avoidable hospitalization and 66% higher rate of outpatient visits among vulnerable populations.

"The study's findings juxtapose an antiquated fee-for-service model and value-based care that CMS policy has fostered," says Phillips. "Our industry has long been focused on the triple aim of healthcare: improving the experience of care, the health of populations, and reducing per capita costs of healthcare. In the past four years, that needle was clearly easier to move under CMS guidance."

The Cavulus CEO is a proponent of other CMS reforms, such as sweeping telehealth and virtual care regulations that were critical throughout the pandemic. He believes "these changes will have long-lasting positive effects to modernize the healthcare delivery".

"Medicare Advantage enrollment is growing annually. It's an affordable and increasingly holistic option," asserts Phillips. Given the program's success, others are lobbying for expansion of MA to cover America's uninsured, rather than creating a new public-option from scratch. In July of 2019, Phillips voiced similar sentiments noting "the collaboration of regulatory oversight and private insurers in Medicare Advantage serves as a template the under-65 insurance market should mirror."

ABOUT CAVULUS - Cavulus is a technology driven specialist in Medicare Advantage insurance solutions. The Cavulus Cloud-based Medicare Advantage Platform (Cavulus MAP(TM)) unifies marketing, sales and enrollment operations, and is utilized by many of America's top insurers, including several BlueCross/ BlueShield companies, UPMC Health Plan, Johns Hopkins, Lumeris and United Healthcare. For details visit: www.cavulus.com.

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SOURCE Cavulus