Former Congresswoman Allyson Schwartz announced Wednesday she will step down as president and CEO of the advocacy group Better Medicare Alliance within six months.
Schwartz has been president of the group that advocates for Medicare Advantage issues before Congress and the federal government for six years.
“I look forward to seeing Better Medicare Alliance continue to play an important role in advocating for the innovative care and benefit design in Medicare Advantage,” Schwartz said in a statement Wednesday.
The former congresswoman from Pennsylvania told Fierce Healthcare in an exclusive interview that she is proud of growing the group that first started with 13 allied organizations and now has 150. The organization’s membership ranges from insurers to charities such as Meals on Wheels.
“We have also worked actively with members of Congress and bringing them to a place where they understand the importance of Medicare Advantage to their beneficiaries and know how it works and why it works,” Schwartz told Fierce.
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She pointed to key accomplishments such as the repeal of the Affordable Care Act’s health insurance tax and work on regulations surrounding quality standards and improvements in star ratings.
The regulatory changes have given insurers the ability to “build the platform that is an integrated managed care system that is working to improve outcomes,” Schwartz said.
Schwartz is leaving at a time when administrations and Congress are changing hands with the incoming Democratic Senate and President-elect Biden’s administration. She predicts that the Biden administration and Congress are going to both want to continue to drive value-based care.
“They are also very interested in addressing health disparities and social determinants of health,” Schwartz said. “Those are areas that Medicare Advantage really has demonstrated its value.”
She added that the narrow majority in the Senate, where Vice President-Elect Kamala Harris will break a 50-50 tie, could temper more bold ideas among Democrats. But Democrats and the Biden administration are likely also to pursue some issues that aim to lower costs for consumers, Schwartz said.
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During her last six months at the alliance, Schwartz hopes to introduce and educate new members of Congress about Medicare Advantage.
On the regulatory front, BMA is looking at issues such as risk adjustment and risk assessment given the drops in healthcare use in 2020 and 2021.
The group also vociferously opposes a rule finalized by the Trump administration that eliminates the safe harbor for drug rebates, meaning the rebates could be penalized under federal antikickback law. It instead creates a new safe harbor for discounts offered at the point of sale.
The Pharmaceutical Care Management Association, which represents pharmacy benefit managers, recently announced a lawsuit challenging the rule.
In the longer term, Schwartz sees enrollment in Medicare Advantage continuing to grow and the benefits plans can offer expanding.
"I believe what will continue is the concept of moving the whole system from traditional fee-for-service into more capitated, integrated care,” she said.
Schwartz doesn’t know exactly what she will do next after she leaves the alliance but hinted it will likely be something in the healthcare space.
“This is my passion. This is my calling,” she said. “I moved seamlessly from local government to city government to the federal government and I look forward to what the future might bring for me.”