Co-Authored by John Selby and Diane Hollie
This Annual Enrollment Period will definitely be one to watch. The key themes emerging from the release of 2023 plan data this AEP are:
The common denominator across these key themes is that plans are investing heavily in Medicare Advantage. This is certainly true of large national plans like Aetna, Cigna, Humana, WellCare, and United, but regional and local plans also are following this path.
Plans’ appetite for growth seems to know no bounds. This includes expansion of current service areas as well as entering new markets. The potential to scale existing capabilities and best practices to reach new Medicare beneficiaries can drive both top line growth and increase efficiencies related to Stars and Risk Adjustment. The latter presents the opportunity to create a revenue-generating cycle that can fuel innovation in product design.
New Counites for 2023
The largest Medicare Advantage Plans expanded their footprint for 2023. The chart above shows all the new counties the largest Medicare Advantage Plans are moving into for 2023. Starting in 2023, 95% of all Medicare beneficiaries will now have access to a UnitedHealthcare Medicare Advantage Plan. The Congressional Budget Office (CBO) estimates that by 2023, 52 percent of all Medicare beneficiaries will be covered through Medicare. This is not a stretch, by any means, and will be the first time MA penetration has exceeded 50 percent.
Within the expansion there are also new products being offered and growth of certain types of MA products.
Overall, we are seeing an expansion of PPOs, D-SNPs, and Plans geared towards Veterans across many of the largest sponsors. Humana is partnering with USAA to offer a new Humana USAA Honor with Rx Plan the is geared towards vets but open to anyone. WellCare and Aetna both have plans geared toward Veterans and are expanding these products into their new markets.
All carriers have at least one $0 Plan in the majority of their markets. Another trend is the premiums are either staying the same or are reduced. Also the number of Plans that give back Part B premiums is becoming more popular with the National Carriers.
Growth of SNP programs can be measured on multiple planes. First, the number of D-SNP plans available continues to grow. This tracking the overall growth patterns of MA in general – service area expansions and the introduction of new service areas continue. Second, plans which have become comfortable in the SNP environment are now venturing into more specialized and potentially risky offerings, such as Institutional SNPs and Chronic SNPs.
The growth of SNPs has outpaced that of Medicare Advantage overall and should continue to in 2023 as SNP enrollment exceeds 5 million beneficiaries for the first time.
Another change happening is the number and types of supplemental, SSBCI, and VBID benefits starting to emerge in the market. This is not just with the top plans but with all plans across the country.
Fierce competition means plans must innovate or risk becoming stagnant, or worse. Supplemental benefits continue to grow in popularity and innovation as a result. What once were differentiators – transportation and OTC, for example – are now table stakes. But plans are taking a more holistic view of benefits in relation to their members’ health and needs. This is obviously the case in C-SNPS, but as plans invest in data and analytics, members’ needs are coming into view more clearly. This is yielding new benefit options, such as pest control, companionship, grocery benefits, and home support. Plans are also tailoring Part D benefits to improve access by lowering deductibles, reducing copays, using preferred networks and mail order services, and addressing specific diseases – such as diabetes – through plan design.
More important, perhaps, is the manner in which these benefits are controlled by members through the use of “flex cards,” in which members determine how they will spend the dollars allotted (typically between $150-$200 per quarter). Perhaps the long-discussed age of "
consumerism” is finally upon us in Medicare Advantage.
We expect that once January 2023 enrollment data is released, the combination of plan expansion, SNP growth, and benefit innovation will all contribute to the continued growth of Medicare Advantage.