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HMA experts evaluate differences between Medicare Advantage and Fee-For-Service Medicare responses to the challenges of the COVID-19 pandemic

In a new report released by the Better Medicare Alliance (BMA), HMA colleagues Zach Gaumer and Elaine Henry concluded that the greater flexibility of the Medicare Advantage plan model enabled plans to offer providers additional support during 2020 that were not found within the Fee-For-Service (FFS) Medicare program. The report’s findings were previewed in a recent panel discussion during the BMA’s Medicare Advantage Summit. 

During BMA’s summit, Gaumer and Henry discussed the research methods and findings of their new report, Medicare Advantage Helped Sustain Providers, Enabled Faster Telehealth Adoption During COVID-19. They explained that the information contained in the report was compiled through interviews with health plans and interviews conducted with providers, as well as through an extensive literature review.  

The report itemizes the various challenges faced by providers and health plans during 2020 as well as the solutions both health plans and providers implemented to mitigate these challenges. The report identifies provider challenges such as reduced visit volumes, financial strain, poor communication of COVID-19 guidance with patients, and staff fatigue.  

Providers reported FFS Medicare offered some very helpful coverage expansions during 2020, such as the expansion of telehealth coverage and the loosening of provider scope of practice rules. However, providers also stated that health plans supported them financially during 2020 by making regular capitated payments and by offering them advanced payments.  

Health plans supported providers with administrative solutions, including expanding patient education campaigns and care management programs. In addition, providers stated that they relied on MA plans’ supplemental benefit offerings to serve isolated patients quarantining at home. Providers underscored that many of the supports offered by MA health plans were not available through the FFS Medicare program.  

The new BMA-HMA report concludes that the flexibility of the MA health plan model enabled plans in 2020 to offer providers a broad array of support that was not available through FFS Medicare.