Les Masterson | January 30, 2018
Dive Brief:
• Medicare Advantage ended 2017 with nearly 21 million enrollees, a nearly 8% increase over the figure from the previous year, reported Axios. However, there are still only a handful of payers that dominate the MA market.
• The top MA payer, UnitedHealth Group, increased membership 14% to 5.24 million members and Humana remained in second with 3.51 million members, a membership increase of 7%. Aetna’s MA enrollees jumped 21% to 1.71 million members.
• In other MA news, the CMS released a report that showed online provider directory errors remain a problem.
Dive Insight:
MA remains popular with both the Medicare population and payers and now accounts for about one-third of Medicare patients.
Though payers are looking to expand their MA offerings as some move away from the Affordable Care Act exchanges, the market remains dominated by a small number of national insurers. UnitedHealth has nearly one-quarter of the MA market. The top four MA payers control more than half of the market.
Stability makes the MA market attractive, with newly eligible Medicare recipients daily. Medicare Advantage also pays better than companies taking part in Medicaid, for example.
Those members have usually had employer-based health insurance, so they don’t have pent-up healthcare needs when they join MA. The payment model is beneficial to payers, which receive money upfront to cover people with high healthcare costs. All of this creates a stable market and is why MA premiums are expected to decrease by 6% this year.
The MA market is stable, but not perfect. There have been ongoing issues with MA organizations’ online provider directories. In a recent report, the CMS said it analyzed MA online directory entries between September 2016 and August 2017. The review of 64 MA organizations, which account for about one-third of MA organizations and more than 6,800 providers, found 52% of provider directories had at least one inaccuracy. The inaccuracies included the wrong location and whether the provider was accepting new patients.
The review was the second conducted by the CMS. The agency is planning a third review to see if accuracy improves. The CMS said the MA organizations should engage with providers to improve directory accuracy. The agency suggested organizations perform self-audits of directory data, work with practices to ensure accuracy and develop better internal processes for members to report errors.
CMS will release preliminary payment rates and policies for 2019 expected on Wednesday.
Source: Healthcare Dive
https://www.healthcaredive.com/news/medicare-advantage-membership-grows-almost-8/515864/