Health insurers are already making moves to expand their Medicare Advantage markets for 2023 despite … [+]
Health insurers are already making moves to expand their Medicare Advantage markets for 2023 despite uncertain financial markets and scrutiny of certain business practices.
These efforts to expand their privatized Medicare plans into latest states and counties come despite roiled financial markets that might slow funding for some firms and federal investigations into how these firms calculate risk adjustments and bill for sicker patients.
In the approaching weeks, established health insurers including UnitedHealth Group’s UnitedHealthcare, CVS Health’s Aetna, Cigna and Elevance Health, formerly Anthem, are expected to report strong second quarter performance of their Medicare Advantage operations. Meanwhile, startups and smaller regional health plans are using funds from their financial backers and investors to launch expansion into latest markets for next yr, despite the competitive landscape and volatile financial markets.
Take Alignment Healthcare, which last week said it could enter the fast-growing markets of Florida and Texas. The startup plan, which became publicly traded last yr, said it sees in Texas and Florida alone a market of “an extra 1.1 million Medicare-eligible seniors, leading to total of 8.2 million Medicare-eligible seniors across 52 counties in six states in 2023.”
Across the country, health insurers have escalated expansions into latest areas, pushing Medicare Advantage enrollment to record highs. Medicare Advantage plans added greater than 2 million beneficiaries for this 2022 coverage yr, boosting this system to 45% of all Medicare enrollment, based on a study earlier this yr by The Chartis Group.
Medicare Advantage plans contract with the federal government to supply extra advantages and services to seniors, similar to disease management and nurse help hotlines with some also offering vision, dental care and wellness programs. And lately, the Centers for Medicare & Medicaid Services has allowed Medicare Advantage plans to cover more supplemental advantages, adding to their popularity amongst seniors.
And while federal regulators and Congress have begun evaluating certain Medicare Advantage business practices, the privatized profit program for seniors retains support from the Biden administration and bipartisan members of Congress.
As one example, the Centers for Medicare & Medicaid Services in April announced an 8.5% revenue increase for Medicare Advantage plan payments for 2023. Meanwhile, the expansion rate was set at 4.88%, which was higher than a proposed rate increase announced earlier this yr.