Donald Trump's second term as president likely will have significant implications for healthcare, including the Medicare Advantage program, which provides health coverage to more than half of the nation's older adults.
Medicare Advantage, the private insurance option within Medicare, has grown significantly in recent years, and Mr. Trump's background in deregulation and market-driven approaches may continue to favor policies supporting the growth and flexibility of MA plans.
In a Nov. 6 article published in Forbes, Sachin Jain, MD, president and CEO of SCAN Group, suggested key changes the new administration should consider to improve MA, including multiyear plan enrollment, rebuilding trust in healthcare through brokers, using technology to adjudicate risk coding in real time and realigning star ratings to focus more on outcomes over processes.
"Every health plan, however, should be able to tell prospective customers how well their members have fared after common health milestones. There is solid data about what separates good from great care on these and other important fronts, so we should compel plans to compete on how well they manage the moments that matter," Dr. Jain said. "The incoming Trump administration might also consider varying broker commissions based on the star rating of the plan to incentivize brokers to match Medicare beneficiaries with higher performing plans."
However, the specific impact of Mr. Trump's administration on MA remains uncertain — particularly in areas including health policy appointments, vaccine communication and overall support for private insurance.
"I have concerns about issues like vaccines, particularly for our senior population with flu and COVID vaccinations. It's essential for us to communicate effectively — not just from a reporting perspective, but also with our members," Angela Perri, Chief Medicare Officer of UPMC Health Plan, said during a Nov. 6 panel at the Becker's Fall Payer Issues Roundtable. "There's so much information out there about health and healthcare, and as payers and providers, it's our responsibility to establish the facts and communicate them consistently."
This is how stakeholders can have a common understanding and a shared foundation for healthcare-related decisions, considering not only policy implications but also what this means at the patient level, according to Ms. Perri.
"At the end of the day, every patient has decisions to make about their care. Physicians present the facts as best they can, and as insurers, we advocate for care coordination, in-home services and other approaches to reduce healthcare costs while maintaining a focus on coordination," she said. "These are things everyone can understand, and if we concentrate on universal aspects essential to health — especially for seniors — to support their independence, we're focusing on what truly matters in the coming years."
Erik Johnson, senior vice president of Optum Advisory Services, said he believes Mr. Trump's second term may not have a significant impact on the future of MA.
"Medicare Advantage is very popular, and I think this administration, much like the previous one, values private insurance," Mr. Johnson said. "I don't believe they're going to want to take an 'L' on something that is so popular among beneficiaries and something the agency is so committed to."
Krystal Revai, MD, associate chief medical officer of Health Alliance Medical Plans, echoed Mr. Johnson's comments and admitted that much is uncertain.
"We can't predict what he will do," Dr. Revai said. "I don't know if the key appointments he makes, based on his experience and connections, will be good or bad for Medicare Advantage."