Despite unstable financial markets and criticism of some business practices, health insurers are already taking steps to increase their Medicare Advantage markets for 2023.
These efforts to expand their privatized Medicare programs into new states and counties will continue, notwithstanding the turbulent financial markets that may restrict funding for some businesses and regulatory inquiries into how these businesses determine risk adjustments and bill for sicker patients.
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Startups and smaller regional health plans leverage funds from their financial backers and investors to launch expansion into new regions in the coming year despite the competitive environment and unstable financial markets.
Consider Alignment Healthcare, which announced this week that it would enter the rapidly expanding Florida and Texas markets. According to the starting plan, which went public last year, there will be “an extra 1.1 million Medicare-eligible seniors in Texas and Florida alone, resulting in a total of 8.2 million Medicare-eligible seniors across 52 counties in six states in 2023.”
Health insurance companies have intensified their expansions into new regions around the nation, driving Medicare Advantage membership to all-time highs, according to a recent survey conducted earlier this year by The Chartis Group,
Twenty-eight million people are currently enrolled in Medicare Advantage, which accounts for 45% of all Medicare recipients. This represents a +3 percent point increase in penetration over 2021 and a +9 percent increase in overall program enrolment. These findings are consistent with the Medicare Advantage products’ excellent value proposition and the industry’s ongoing efforts to produce new value for its customers. With this development, the competitive environment for health plans that manage these products is continuing to change. Some themes from analysis from the previous year have persisted, while others have taken on new forms in the shifting economy.
Enrollment in Medicare as a whole increased by 1 million this year. Though the increase has slowed relative to previous years, a large portion of this slowdown is probably due to the 300,000 COVID-19 deaths among those aged 65 and older per year in 2020 and 2021.
At the expense of 1.3 million beneficiaries of Original Medicare, the Medicare Advantage market added +2.3 million lives. The number of people switching from original Medicare to Medicare Advantage is at an all-time high. In comparison to 42 percent last year and 37 percent in 2019, the market share for Medicare Advantage has increased to 45 percent of all Medicare enrollment.
The race to reach 50% continues, with at least 50% of eligible beneficiaries using Medicare Advantage products in 11 of the 50 states. This is a significant industry milestone that has been long expected, even though it is primarily symbolic. Our research points to market penetration of 50% for Medicare Advantage by 2025.
The federal government increases Medicare Advantage payments
The Biden administration and Congress continue to support the privatized senior benefits program known as Medicare Advantage. However, federal regulators and Congress have started to examine certain Medicare Advantage business practices.
One is the 8.5 percent income increase for Medicare Advantage plan payments for 2023 announced by the Centers for Medicare & Medicaid Services in April. At 4.88 percent, the growth rate was higher than the proposed rate hike announced earlier this year.
The assumption that more Medicare enrollees will receive care that had been put off throughout the epidemic is a significant factor in the increase, which is one of the greatest ever for Medicare Advantage. The increase may encourage more health insurers to enroll in Medicare Advantage or increase their participation in the profitable but divisive taxpayer-funded program, which is expected to cost $450 billion in 2019 — more than the combined budgets of the Departments of Education and Agriculture.
Medicare Advantage plans have agreements with the federal government to offer additional benefits and services to seniors, including nurse help hotlines, disease management, and some vision, dental, and wellness programs. Additionally, the Centers for Medicare & Medicaid Services recently permitted Medicare Advantage plans to offer more supplemental benefits, which has increased their appeal to senior citizens.
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Bio:
For over 20 years, Jeff Boettcher has helped his clients grow and protect their retirement savings. “each time I work with my clients, I’m building their future, and there are few things that are more important to a family than a stable financial foundation.”
Jeff is known for his ability to make the complex simple while helping navigate his clients through the challenges of making the right investment decisions. When asked what he is most passionate about professionally, his answer was true to character, “Helping my clients – I love being able to solve their problems. People are rightfully concerned about their retirement income, when they can retire, how to maximize their financial safety and future income.” Jeff started Bedrock Investment Advisors for clients who value a close working relationship with their advisors.
A Michigan native, Jeff grew up playing sports throughout high school and into college. While Jeff is still an ‘aging’ athlete, Jeff will take more swings on the golf course than miles running these days. He creates family time, often with weekly excursions to play golf, a hobby he shares with his three young children.
Disclosure:
Investment advisory services are offered through BWM Advisory, LLC (BWM). BWM is registered as an Investment Advisor located in Scottsdale, Arizona, and only conducts business in states where it is properly licensed, notice has been filed, or is excluded from notice filing requirements. This information is not a complete analysis of the topic(s) discussed, is general in nature, and is not personalized investment advice. Nothing in this article is intended to be investment advice. There are risks involved with investing which may include (but are not limited to) market fluctuations and possible loss of principal value. Carefully consider the risks and possible consequences involved prior to making any investment decision. You should consult a professional tax or investment advisor regarding tax and investment implications before taking any investment actions or implementing any investment strategies.
