Projecting Medicare Advantage Enrollment: Expect the Unexpected?

Posted: September 21, 2013 in Uncategorized
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Heads UP!!!  Medicare open enrollment is coming soon to a town near you.  While the health policy world is preparing for the continued implementation of the Affordable Care Act, private insurers are getting ready for this year’s Medicare open enrollment period in October.  This period allows Medicare beneficiaries with an opportunity to enroll in a new Advantage plan or switch plans.  Simultaneously, the insurance carriers are deciding whether they will offer more or less Medicare Advantage Plans in 2014. 

The ACA has reduced the formal benefit payments due to overpayments to plans but is offering incentive “bonuses” for those who perform better quality services and rated better.  Due to the recent cut in payments, there is an expected decline in Medicare Advantage enrollees.  The Centers for Medicare and Medicaid Services (CMS) has suggested that there is a need to increase and improve upon the incentive-based system.


Despite these predictions, Medicare Advantage numbers actually appear to be climbing (by about 30%).  Although there is no clear reason for the climb, one effect that appears to be significant is the increase in incentive payments.  This may be effectively offsetting the payment reduction, allowing more plans to remain.  There is uncertainty about whether this current boost in enrollees is based on dollars and cents or maybe the aging population is dictating the numbers.  This is something worth keeping an eye on, especially if you rely on patients who have Medicare Advantage.






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