2018 Healthcare Outlook

TREND #2: MEDICARE ADVANTAGE'S RISING STAR

ACA insurance exchange uncertainty has payers saturating an already crowded Medicare Advantage (MA) market. A new Navigant analysis shows how MA star ratings improvements can grow plan enrollment and revenue.

MA plans are appealing to aging baby boomers, providers, and payers, and they're growing in popularity.

MA ENROLLEES1

INPATIENT SPENDING2

WITH THE NATION'S LARGEST COMMERCIAL PAYERS AGGRESSIVELY EXPANDING MA OFFERINGS3 AND CHALLENGING PLAN GROWTH...

INCREASING MA STAR RATINGS IS KEY TO ATTRACTING NEW ENROLLEES4, DRIVING REVENUE.

MA plans are appealing to aging baby boomers, providers, and payers, and they're growing in popularity.

Navigant MA Star Ratings Analysis*

*From publicly available data on 500 MA contracts, 2012-2016

MA plans are appealing to aging baby boomers, providers, and payers, and they're growing in popularity.

MA ENROLLEES1

MA ENROLLEES1

INPATIENT SPENDING2

INPATIENT SPENDING2

WITH THE NATION'S LARGEST COMMERCIAL PAYERS AGGRESSIVELY EXPANDING MA OFFERINGS3 AND CHALLENGING PLAN GROWTH...

INCREASING MA STAR RATINGS IS KEY TO ATTRACTING NEW ENROLLEES4, DRIVING REVENUE.

MA plans are appealing to aging baby boomers, providers, and payers, and they're growing in popularity.

Navigant MA Star Ratings Analysis*

*From publicly available data on 500 MA contracts, 2012-2016

MA ENROLLEES1

INPATIENT SPENDING2

IMPROVEMENTS

1-star rating improvement could increase annual plan enrollment 8%-12%

1-star rating improvement could increase annual plan enrollment 8%-12%

Improving from a 3-star to 4-star rating could increase plan revenue 13%-17%

Improving from a 3-star to 4-star rating could increase plan revenue 13%-17%

Improving from a 3-star to 4-star rating could increase plan revenue 13%-17%

Improving from a 3-star to 4-star rating could increase plan revenue 13%-17%

WHAT PAYERS NEED TO DO

Subheadline About the Benefits

Increase collaboration with providers

Increase collaboration with providers

Benefit or idea number two should go here. Be brief with sentences.

MA plan attractiveness often connected to providers that

INVEST RESOURCES TO CLOSE CARE GAPS

Benefit or idea number two should go here. Be brief with sentences.

Plans should seek provider arrangements to

SHARE QUALITY AND EFFICIENCY IMPROVEMENTS

that enhance plan satisfaction, financial benefits

Benefit or idea number two should go here. Be brief with sentences.

MA plan attractiveness often connected to providers that

INVEST RESOURCES TO CLOSE CARE GAPS

Benefit or idea number two should go here. Be brief with sentences.

Plans should seek provider arrangements to

SHARE QUALITY AND EFFICIENCY IMPROVEMENTS

that enhance plan satisfaction, financial benefits

  1. Medicare Advantage 2017 Spotlight: Enrollment Market Update; Kaiser Family Foundation; 6/6/17. 
  2. The Facts on Medicare Spending and Financing; Kaiser Family Foundation; 7/18/17.
  3. Anthem To Buy Medicare Advantage Plan In Lucrative Florida Market; Forbes: 9/20/17.
  4. CMS releases star ratings for Medicare Advantage and drug plans, Kaiser earns top marks; Healthcare Finance; 10/11/17. 

Additional trend insights via LinkedIn: Medicare Advantage’s Rising Star

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