May 13, 2024- Vizient, Inc. hosted a policy briefing titled, “Medicare (DIS)Advantage: How MA Plans are Implementing Policies to Limit Access to Care,” at the Rayburn House Office Building on May 8. The briefing, attended by a standing-room only crowd of more than 80 congressional staff and industry stakeholders, focused on the disruptions caused by Medicare Advantage (MA) organizations and how hospitals are navigating the myriad challenges to provide timely and seamless care to MA beneficiaries.
The panel of experts highlighted the ongoing challenges with certain MA plans, such as confusion among beneficiaries about their coverage, excessive prior authorization denials, reimbursement issues and gaps in data reporting to CMS.
The panelists proposed several solutions to enhance patient access and care delivery. Recommendations included requiring MA plans to have provider access comparable to Medicare, streamlining the prior authorization process, reducing timelines for responding to denials, and improving MA data reporting on prior authorizations and denials, among other recommendations.
Vizient remains committed to collaborating with policymakers, industry stakeholders, and healthcare providers to advance policies and initiatives that improve healthcare delivery and patient care outcomes across the nation.