Medicare Advantage enrollment is on the rise, but the pace of growth slowed in 2022. As enrollment climbs, CMS is considering a slew of policy changes, which some groups say could cut benefits.
Here are 14 Medicare Advantage updates Becker's has reported since Feb. 15.
- More insurance brokers said they would enroll in traditional Medicare over Medicare Advantage in focus groups conducted by the Commonwealth Fund.
- The top 10 Medicare Advantage-focused startups have raised more than $20 billion combined in venture funding, according to a report published in Health Affairs.
- Medicare Advantage plans grossed $1,730 per enrollee in 2021, far exceeding margins for individual, group and Medicaid markets, according to the Kaiser Family Foundation.
- Medicare Advantage beneficiaries are less likely to be hospitalized for ambulatory care-sensitive conditions than their counterparts in traditional Medicare, but this care is shifted to other settings, a study published in JAMA Health Forum found.
- The American Dental Association says there needs to be more data about Medicare Advantage dental benefits. In comments submitted to CMS on the agency's proposed MA rule changes for 2024, the ADA's president and executive director urged the agency to collect more data on the types of dental benefits available and used by MA beneficiaries.
- Humana is projecting to add at least 775,000 new Medicare Advantage members in 2023, upping its outlook from its last prediction of 625,000 because of higher than anticipated sales volumes and retention.
- Medicare Advantage enrollment continues to grow — but in Illinois, California, Connecticut and the District of Columbia, enrollment declined for 2023.
- Medicare Advantage enrollment reached nearly 31.2 million, according to a February report from CMS.
- The pace of Medicare Advantage growth slowed in 2022, a report from healthcare consulting group Chartis found. At least 1.5 million new beneficiaries enrolled in MA plans for 2023 — down from 2.3 million in 2022, 2.2 million in 2022 and 1.9 million in 2021.
- Debbie Zimmerman, MD, corporate chief medical officer at Essence Healthcare, sat down with Becker's to discuss how Essence's HMO plan has consistently received a five-star rating from CMS.
- A group of 70 lawmakers pressed CMS on further Medicare Advantage reforms, as the agency considers implementing prior authorization reforms and other changes to the program.
- Proposed changes to Medicare Advantage payments could cut benefits for members by $540 per year, according to a report commissioned by the Better Medicare Alliance. HHS said Medicare Advantage audits are "unequivocally not cuts" in funding.
- In January, CMS said it will implement stricter auditing practices around Medicare Advantage plans, but payers and policy experts say they have a lot of questions about the next steps forward. Here are five key unanswered questions about CMS' new rule.
- Medicare Advantage plans deny the most inpatient level-of-care claims among payer categories, according to a report from Crowe Revenue Cycle Analytics.