IRVING, TX — Vizient, Inc. hosted a policy briefing on Capitol Hill titled, "Medicare (DIS)Advantage: How MA Plans are Implementing Policies to Limit Access to Care," at the Rayburn House Office Building. The event featured remarks from Reps. Jasmine Crockett (D-TX) and Marc Veasey (D-TX), with recorded remarks provided by Rep. Valerie Foushee (D-NC) and was sponsored by Rep. Jake Ellzey (R-TX). 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.

"Having recently met with healthcare providers in Texas's 30th district, I am acutely aware of the challenges posed by Medicare Advantage's problematic policies," said Rep. Crockett. "It's imperative we resolve these issues to prevent unnecessary delays or denials of care. Safeguarding patient access to essential healthcare services remains a top priority, ensuring our hospitals are supported, not hindered, by administrative burdens. I appreciate Vizient's leadership in facilitating this important discussion to help drive meaningful change."

Jenna Stern, associate vice president of regulatory affairs and public policy at Vizient, moderated a discussion featuring a distinguished panel of key healthcare leaders, including:

• Christopher K. Dorman, MA, MBA-HCM, FACHE, president & CEO, Southwell – Tift Regional Health System, Inc.
• Jeff Francis, MBA, vice president & CFO, Methodist Health System
• Janet Hadar, MSN, MBA, FACHE, president, UNC Hospitals

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.