HHS Secretary Alex Azar on Tuesday hinted that Medicare Advantage plans could see pay boosts as part of the Trump administration's strategy to tackle maternal mortality rates, social determinants of health and rural healthcare access.
"We can also enhance value through payments in Medicare Advantage, where we want to open up more opportunities for MA plans and entities they work with, including creative value-based insurance design arrangements, moving care to the home and community, and new ways for MA plans to improve a patients' health over the long term," Azar said at the Better Medicare Alliance's policy summit.
Those innovative arrangements include the primary-care models that Azar and CMS Administrator Seema Verma announced earlier this year, which could be a boon to Medicare Advantage business.
In April, administration officials unveiled their plan to shift fee-for-service into a global pay structure where physicians, hospitals, clinics or Medicare Advantage plans would assume more risk.
Stakeholders have predicted the strategy is ripe with opportunity for Medicare Advantage business.
But beyond this effort, Azar hinted that HHS will use their pay models to try to combat the spiking maternal mortality rates that the Trump administration and lawmakers on both sides of the aisle recognize as a crisis.
"We need to protect our mothers, and that starts by developing a comprehensive strategy that improves payment incentives, boosts adoption of best practices and addresses preventable risks," Azar told the audience.
Overhauling payments could also prop up rural healthcare, including access to specialists, he said.
"Rural access to care can be a huge challenge: There are 263 specialists for every 100,000 Americans in urban areas, compared with just 30 per 100,000 in rural areas," Azar said. "But we believe we can design new ways to sustainably finance care in these areas, supporting innovation and providing flexibility to meet these communities' health needs."
Medicare Advantage could also play a role in the administration's plan to address social determinants of health.
"You've already seen one effort to address this through new supplemental benefits in Medicare Advantage, like home-delivered meals, transportation and home modifications," he said. "We want to go further, and we look forward to working with all of you to think about how best to do that."
But Azar remained vague about President Donald Trump's recent executive order on price transparency for hospitals and insurance companies. The practical impact of that order is largely up to HHS' interpretation, but Azar didn't offer any details on when the regulations will be released or what they could like.
Instead, he characterized the goal of the Trump order as making price information "available to patients easily and immediately, before they ever have to make a healthcare decision."
"Under the EO, hospitals would have to disclose information about their negotiated rates in a public format that is understandable and usable for patients," he said. "Insurance companies will be required to provide patients with information about out-of-pocket costs before they receive services, rather than weeks later when they get the bill. Surprise bills will be a thing of the past."
