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What's the Advantage?

What's the Advantage?

When I think about hot topics in health care these days, the escalating adoption of Medicare Advantage is at the top of the list.

Enrollment in MA plans has more than doubled in the last 10 years to about 24 million in 2020, according to the Kaiser Family Foundation. About 42% of Medicare beneficiaries were enrolled in MA plans in 2021, KFF says.  

Seema Verma, the former CMS Administrator, told HME News in October that, “We should see greater adoption in Medicare Advantage plans, where private plans can be more flexible and nimble.” She believes enrollment in MA plans could hit 50% in no time. 

Historically, a handful of insurers have had the MA market locked up. UnitedHealthcare and Humana accounted for nearly half of all MA enrollees nationwide in 2021, according to KFF. 

But there are signs that might be changing. 

When I emailed AAHomecare’s Laura Williard about the HME Newspoll for the March issue, she wrote: “There has been huge growth in the number of Medicare Advantage plans offered and many new firms entering the market.” 

I did take note, amid the flurry of earnings calls in February, that Mario Schlosser, the co-founder and CEO of Oscar Health, a health plan focused on virtual care, said, “We have a ton more runway ahead of us in delivering MA growth.” 

The results of our Newspoll bear all of this out:  

  • 87% of respondents report an increase in the number of insurers offering MA plans 
  • 54% report they serve six or more MA plans 
  • 90% report they have seen an increase in the past year in the number of patients who have MA plans vs. traditional Medicare
  • 38% report a 15% or more increase in the number of patients who have MA plans vs. traditional Medicare

Williard also wrote to me: “It’s my belief (the growth in the number of MA plans) offers opportunity for the industry outside the payer giants.” This makes sense: With more insurers offering MA plans, providers improve their chances of securing contracts. 

The boots-on-the-ground sentiments about MA plans are more complex. Respondents to the poll report lower reimbursement, higher administrative burdens, inconsistent policies, “plan jumping” – just to name a few of their concerns. 

But it’s going to be a market that’s hard to ignore.

“To stay successful in this business, you need to service Advantage plans,” wrote one respondent. “More plans mean more patients.”


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