October 6, 2021
The Honorable Ron Wyden
Chair
Committee on Finance
United States Senate
219 Dirksen Senate Office Building
Washington, DC 20510
The Honorable Mike Crapo
Ranking Member
Committee on Finance
United States Senate
219 Dirksen Senate Office Building
Washington, DC 20510
Dear Chairman Wyden and Ranking Member Crapo:
On behalf of America’s Physician Groups (APG), I am writing to express our association’s support of the proposal currently included in your budget reconciliation legislation that expands coverage within the Medicare program to include dental, vision, and hearing benefits. Offering this additional coverage of these critical services under the Medicare program will allow beneficiaries nationwide to receive much needed care that will contribute to the improvement of their overall health. In addition to our support for this expansion, we would like to offer a recommendation of how to best account for this additional coverage within the Medicare Advantage (MA) program to ensure that MA providers are not financially disadvantaged as a result.
About America’s Physician Groups
APG is a national professional association representing over 300 physician groups, approximately 195,000 physicians, and the nearly 45 million patients they care for. Our tagline, “Taking Responsibility for America’s Health,” represents our members’ vision and efforts to move away from the antiquated fee-for-service (FFS) reimbursement system where clinicians are paid “per click” for each service rendered rather than on the outcomes of the care provided. Our preferred model of capitated, delegated and coordinated care avoids incentives for the high utilization associated with FFS reimbursement. APG is committed to Medicare Advantage and the flexible, affordable, and efficient care it provides for seniors. APG member organizations are working diligently to rise to the challenge presented by the COVID-19 pandemic. We are focused on the transition of most patient visits to telehealth as a best practice in slowing the spread of the virus and keeping patients safe.
Comments
The extension of Medicare coverage to include dental, vision, and hearing benefits is essential in moving toward increasing access to care for all Americans and achieving the goal of greater health equity. For example, many Medicare beneficiaries lack dental coverage and with so many beneficiaries living on fixed incomes, their options for finding affordable coverage are limited. Oral health issues often develop into larger, increasingly serious health issues such as diabetes and heart disease, making immediate treatment a necessity and an essential part of preventative treatment. Barriers to dental health has a resulting effect on overall health thus expanding dental benefits within the Medicare program is an effective way to improve the overall care that Medicare beneficiaries receive. Many of these barriers to dental, and vision and hearing services are most pronounced for people in underserved communities. Adding coverage in all three of these areas to Medicare represents a major step in addressing health inequities and improving our nation’s overall health.
One underlying issue in the expansion of Medicare benefits that we did wish to bring to your attention is that Part C benchmarks are not adjusted to account for these additional coverage obligations. If the dental, vision, and hearing benefits are implemented with no adjustments to Part C benchmarks, healthcare organizations that participate in the MA program could potentially face additional financial liability, as well as MA beneficiaries potentially facing increased premiums. It is important that Medicare Part B beneficiaries have their coverage options expanded so that the most vulnerable patients within the program are able to receive full medical care. However, patients in other viable programs such as MA must also have their own current care protected and unchanged as efforts are made expand inclusion for all enrollees.
Thank you for your attention to the above comments. Again, we reiterate our robust support for the addition of these benefits to the Medicare program. We look forward to continuing to work with you throughout this process. Please feel free to contact Valinda Rutledge, Executive Vice President, Federal Affairs, (vrutledge@apg.org) if you have any questions or if America’s Physician Groups can provide any assistance as you consider these issues.
Sincerely,
Donald H. Crane
President and CEO
America’s Physician Groups
Click here to download a copy of the letter.
