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January 28, 2016 12:00 AM

AHIP starts early with Medicare Advantage political pressure

Bob Herman
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    Getty Images
    AHIP's Coalition for Medicare Choices pushes for higher Medicare Advantage rates in March 2015.

    America's Health Insurance Plans, the primary lobbyist for the health insurance industry, is funding a “seven-figure” ad campaign that targets Medicare Advantage and aims to put pressure on the Obama administration to stabilize funding for the private version of Medicare.

    The announcement comes just weeks before the CMS puts out its advance rate notice for 2017 Medicare Advantage plans, the annual wonky document that lays out the program's latest payments and policies. The notice, which will be released Feb. 19, marks the start of 45 days of insurer lobbying and political hand-wringing over a program that now covers almost 18 million seniors, according to the latest CMS data.

    “Medicare Advantage today is seen as the model of what's working,” Marilyn Tavenner, AHIP's CEO and former CMS chief, said during a conference call.

    Insurers have invested more time and resources, as well as lobbying campaigns, into their private Medicare products because they've been viewed as a profitable growth engine to help offset the flailing commercial market.

    AHIP will funnel the campaign through its consumer group, the Coalition for Medicare Choices, which includes 2 million seniors. In addition to paid TV and digital advertising and a social media bombardment, AHIP's coalition seniors will voice their concerns to legislators in every state, said Beth Leonard, AHIP's executive vice president for public affairs.

    The insurance industry nabbed a 1.25% average increase to their 2016 Medicare Advantage benchmark payments during last year's rate scuffle. But the CMS held firm and said all Advantage insurers would have to use a new, more accurate risk-adjustment model. That drew the ire of the industry, which argued the new risk scoring hurts plans that cover seniors with multiple chronic conditions. Supporters said improved risk adjustment would reduce potential fraud and upcoding.

    AHIP and other lobbying groups, like the Better Medicare Alliance, will undoubtedly advocate for changes to risk scoring. Baseline payments will also be front and center. The Affordable Care Act phased in Medicare Advantage payment cuts over six years, starting in 2012, which means the last of the reductions will end by 2017.

    In December, the CMS issued a sneak peak at the Medicare fee-for-service growth rate, one of the key elements of determining final Advantage rates. The agency said traditional Medicare spending will increase by 3.1% in 2017, but the December number almost certainly will change.

    “The growth rate is an important part but only one part of the calculation of rates,” said Mark Hamelburg, AHIP's senior vice president and lobbyist for federal healthcare programs.

    AHIP will work this campaign without two former members, Aetna and UnitedHealth Group. Those two insurers also happen to be two of the largest Medicare HMOs in the country. They also happen to be the founding members of the Better Medicare Alliance, which focuses on Medicare Advantage.

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