5/07/2019

Four Medicare Advantage Trends to Watch

Charlotte Wiemerslage, MBA, Product Marketing Manager, Product Strategy and Experience

Given the national conversation around the so-called “silver tsunami,” it should come as no surprise that more than 10,000 Americans will age into the Medicare system every day through 2030. But did you know that, according to the Centers for Medicare and Medicaid, one in three 2019 enrollees will ultimately select a private Medicare Advantage plan? Here are four things you need to know about the state of Medicare Advantage:

1. More payers, more plans
   
   From innovative startups serving targeted populations to insurance giants entering the Medicare Advantage market for the first time, today’s retirees have more options than ever before. Payers are expected to offer 600 new Medicare Advantage plans in 2019, bringing the market total to 3,700 nationwide CMS anticipates that 91% of enrollees will have access to 10 or more Medicare Advantage plans in their area.
2. Plan options in all shapes and sizes
   
   When it comes to Medicare Advantage, options for new enrollees extend far beyond basic HMOs and PPOs. Two specialty plans gaining traction in the private market are special needs plans (SNPs) and high-deductible Medicare Savings Account (MSA) plans. Whereas MSA plans cater to younger, healthier enrollees looking for affordable coverage, SNPS are designed specifically for individuals living with chronic conditions like asthma, diabetes, or coronary artery disease. Enrollment in SNP plans, in particular, has grown 55% over the last five years.
3. Supplemental benefits coverage coming soon
   
   CMS made a splash in spring 2018 when it announced new and expanded reimbursements for supplemental Medicare Advantage benefits like at-home care, palliative care, and telehealth. They upped the ante in 2019 by announcing more rule changes around nonmedical services that address social determinants of health. While payers will need time to translate these developments into market-ready products, these new offerings will no doubt attract new insurers and enrollees alike to Medicare Advantage.
4. Medicare Advantage on FHIR
   
   Another game-changing announcement from CMS? Interoperability and data sharing requirements for Medicare Advantage, state Medicaid/CHIP fee-for-service, Medicaid/CHIP managed care, and ACA-backed marketplace programs. The proposed rule calls on payers to leverage FHIR standards to help members access their electronic health records across the entire continuum of care. Expect more details from CMS after the comment period for stakeholders ends in June.

To serve this growing member demographic, Healthwise offers health plans robust online, print, and mobile education solutions for care management, triage, and wellness. Provide a better experience for your Medicare Advantage members with consistent, relevant health information and tools that help them adopt healthy behaviors and improve outcomes. Learn more at https://www.healthwise.org/healthplans.