Medicare Advantage in the headlines: 7 recent updates

Here are seven recent updates to note: 

1. Low star ratings put Medicare Advantage plans at risk for a “Darwinian death spiral,” according to Sachin Jain, MD, president and CEO of SCAN Group. 
2. Insurers are trying to maintain stability for enrollees amid a tumultuous Medicare open enrollment.  
3. Eighteen insurers have exited Medicare Advantage markets for 2025, with more than 1.8 million people currently enrolled in plans that will not exist next year, according to a report from OliverWyman. Market exits by Humana, Aetna and UnitedHealthcare collectively affect nearly 70% of those 1.8 million individuals.
4. Medicare Advantage companies brought in billions in “questionable” payments found during in-home visits and chart-reviews, HHS’ Office of Inspector General claimed in an audit. Insurer groups called the report “misleading.” 
5. CMS lifted an enrollment suspension on a UnitedHealthcare subsidiary’s Medicare Advantage plan following three years of not meeting the required 85% medical loss ratio.
6. Several insurers are disputing CMS’ Medicare Advantage star ratings in court. Humana, Centene and UnitedHealthcare have all filed challenges to their star ratings. For 2025, just seven plans received a five-star rating from CMS, down from 38 in 2024. 
7. Devoted Health, BCBS Michigan, Highmark Health and Aetna were named the best Medicare Advantage carriers for 2025 by U.S. News & World Report. 

At the Becker's 5th Annual Fall Payer Issues Roundtable, taking place November 2–3 in Chicago, payer executives and healthcare leaders will come together to discuss value-based care, regulatory changes, cost management strategies and innovations shaping the future of payer-provider collaboration. Apply for complimentary registration now.