5 Objectives From the CMS RFI to Better Medicare Advantage

The request for information aligns with CMS' Strategic Pillars.

CMS released a request for information (RFI) that seeks "feedback on ways to strengthen Medicare Advantage (MA)." The goals are to align MA with CMS' Vision for Medicare and its Strategic Pillars through increased and diverse stakeholder input.

In a related press release, CMS administrator Chiquita Brooks-LaSure stated: "Medicare Advantage is a critical part of CMS' vision to advance health equity; expand access to affordable coverage and care; drive high quality, person-centered care; and promote affordability and sustainability of Medicare," adding: "Medicare Advantage plans are essential partners in this work."

The agency seeks other partners as well.

Dr. Meena Seshamani, the agency's deputy administrator and director of the Center for Medicare, added: "We see a huge opportunity for partnership with as many stakeholders as possible to better understand how care innovations are changing outcomes and costs and how Medicare Advantage is working for enrollees."

The following summarizes RFI components, with future articles planned that investigates each in more depth.

Five RFI objectives

The RFI components include the following details:

• Advance Health Equity. CMS seeks "examples of policies, programs, and innovations," related to:
   
  • screening, documentation, and services related to the drivers of health (DOH; also known as the social determinants of health, or SDOH) care gaps
     
  • type, source, and use of both data and algorithms to identify need while preventing bias
     
  • specific DOH services, including food/nutrition and physical activity
     
  • contracting with community-based organizations
• Expand Access: Coverage and Care. The agency requests information on plan:
   
  • marketing, education, and plan shopping/selection
     
  • telehealth approaches
     
  • network adequacy
     
  • supplemental benefit design
     
  • utilization management and prior authorization
• Drive Innovation to Promote Person-Centered Care. CMS focuses on MA plans and value-based care (VBC)—including provider and patient experiences, model design, trajectory, preferences, and outcomes—as well as what the agency can do to improve and plan response to CMMI resets.
   
• Support Affordability and Sustainability. CMS seeks input on payment, risk, and MLR methodologies.
   
• Engage Partners. CMS seeks ideas to increase stakeholder collaboration for individual, community, and systemic benefit.

While distinct from CMS rulemaking, similar parameters apply to RFI responses including a 30-day public comment period from date of publication. August 1 is the RFI's official publication date, making the comment window open until August 31.