Enrollment in Medicare Advantage plans climbed this year, despite the fact that payment rates were frozen
NATIONAL REPORTS-Enrollment in Medicare Advantage plans climbed this year, despite the fact that Medicare Advantage payment rates were frozen at 2010 levels, according to recent research conducted by the Kaiser Family Foundation.
One quarter of Medicare beneficiaries are now enrolled in Medicare Advantage plans. Within these Medicare Advantage plans, 65% of Medicare beneficiaries are enrolled in HMOs, 27% in local or regional PPOs, and just 5% in private fee-for-service plans.
This increase in Medicare Advantage enrollment can be traced to two key trends. The first is the sheer number of new beneficiaries as more of the baby boom generation reaches the age of Medicare eligibility.
The second trend driving the popularity of Medicare Advantage plans is the fact that, prior to enrolling in Medicare, more of the Medicare-eligible population have experience and have become comfortable with managed care plans.
"Many of these people are familiar with managed care, which was not the case for the people going into Medicare 10 years ago," notes Donahue. "They are used to having copayments. They are used to having some type of health insurance. They are more aware of the need for health insurance."
Other issues are also playing a role in the growing popularity of Medicare Advantage plans. As larger hospitals and more well-known providers participate in managed care plans, individuals will be more drawn to Medicare Advantage plans, says Christina Frizzera, senior advisor with Leavitt Partners in Salt Lake City, Utah. For example, in Maryland, the entry of Johns Hopkins University and the University of Maryland Medical Center have served to make Medicare Advantage plans more popular in that region.
We conducted our annual State of the Industry survey in the early part of November 2023. The survey had 432 respondents, of whom 56% self-reported working for a payer organization (pharmacy benefit manager, insurer or self-insured employer), 34% for a provider organization and the remainder for government or an unspecified “other” category.
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September 29th 2022In this episode of Tuning In to the C-Suite, Managing Editor of Managed Healthcare Executive, Peter Wehrwein, speaks with President of Value Evolutions and MHE Editorial Advisory Board Member, Doug Chaet, FACHE, about value-based care's current standing, the status of select payment models like bundled and episodic, and more.
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