The 'great disruption' coming for Medicare Advantage
09/11/24 at 03:00 AM
The 'great disruption' coming for Medicare Advantage
Becker's Payer Issues; by Jakob Emerson; 9/9/24
Come mid-October, the Medicare Advantage program will enter its annual enrollment period, marked by significant changes for older adults. Among these changes are increased government scrutiny, tighter CMS regulations, reduced base payments, and rising healthcare costs. ... "Taken together, some are calling these cuts 'the great disruption,'" wrote Sachin Jain, MD, CEO of SCAN Group, a nonprofit MA carrier with more than 285,000 members, in a LinkedIn post on Sept. 4. Dr. Jain outlined five key observations about the evolving landscape:
- Benefit stability will win out among beneficiaries over "innovation."
- MA organizations will need to improve care management, including avoiding hospitalizations and proactively managing chronic conditions.
- MA competition will increasingly focus on a plan’s effectiveness and service quality.
- Brokers will become more important than ever.
- Stronger relationships will prevail over "partnering with everyone."