Healthcare execs wary, but willing to give Medicare Advantage plans a shot

A number of U.S. health system executives plan to implement Medicare Advantage strategies, but few are optimistic those strategies will be successful, according to a recent survey by Lumeris.

For the survey, researchers polled 90 executives from major health systems. Of those 90 respondents, 27 percent plan to launch a Medicare Advantage plan in the next four years. However, only 29 percent of respondents with those plans are optimistic their organizations will be successful with the efforts.

"These survey findings are consistent with our conversations with healthcare executives across the country who are feeling a sense of urgency around Medicare Advantage strategies but also realize that this type of work is vastly different than traditional health system operations," said Jeff Carroll, executive director of health plans at Lumeris.

According to Lumeris, executives primarily wanted to launch a Medicare Advantage plan because it provides their organizations with opportunities for greater control of more of the premium dollar compared to fee-for-service Medicare. Executives also cited market and regulatory trends, particularly the fact that declining Medicare margins could negatively affect their organization's finances as a growing senior population seeks more care. 

Executives acknowledged their organizations will face difficulties entering the Medicare Advantage space, including the required financial investment and no expertise in launching such a health plan, Lumeris said.

More than half of respondents (59 percent) reported they will likely get outside help, such as a vendor partner, for the launches.



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