Patrick Phillips, CEO of Medicare Advantage technology company Cavulus, predicted in 2019 that the Medicare Advantage landscape would be disrupted by start-ups — a vision that is a reality three years later.
Mr. Phillips pointed primarily to Humana's January Medicare Advantage outlook cut as evidence of start-ups looking to take over a slice of the market from larger payers.
"Many recent entrants in the MA market are tech-backed start-ups who bring an agile, grass-roots approach to marketing with high-touch customer service that can be cumbersome for a number of dominant insurers who serve millions of members," Mr. Phillips said.
However, other payers have maintained confidence in their Medicare Advantage strategies despite the increasing rise of start-ups scooping up potential members.
Mr. Phillips said outdated workflows and technology are holding dominant payers back from seizing more of the market, claiming that "there's often a reluctance to change."