Medicare Advantage (MA) continues to emerge as one of the most desirable products to beneficiaries, as evidenced in current and projected enrollment figures. This year was one of the largest federal reimbursement increases that the MA industry has seen in over a decade, and Forbes summarized the results well: geography and product expansion, new entrants, richer benefit designs and more competition overall. Given bipartisan political support, we expect to see these trends increase.
The broader health care industry has also noticed MA’s success. We’re seeing mergers and acquisitions at an unprecedented rate as larger insurance entities buy into the MA space. There’s also increased alignment with provider networks and hospital systems as plans jockey for competitive advantages. Since MA plans are obligated to invest the majority of reimbursement on benefits, coverage options are often similar among competitors, leaving advantages to be sought elsewhere.
We believe that one of the biggest advantages and differentiators that plans may be overlooking is member experience. The baby boomer generation aging into Medicare are savvy consumers accustomed to shopping and customer service experiences from companies like Apple, Amazon, Costco, and Netflix. In MA, the shopping, enrollment and subsequent member service interactions can still be frustrating. Forward-looking plans are scrutinizing member experience, but many remain stagnant. In our opinion, it’s an investment in talent, infrastructure, and company culture that plans can’t afford to overlook. The article also mentions startups, which is something we follow closely. New entrants are free from the burden of transformation, so it’ll be interesting to see how these players approach a market that’s prime for disruption.
Learn more by visiting cavulus.com
A Year in Review: A comprehensive look at UPMC Enterprises 2020
Over the last year, UPMC Enterprises, our portfolio companies, and select partners have all supported UPMC’s mission of Life Changing Medicine. In the booklet below, we have compiled highlights from a truly unique year and recognize the team members and projects that have enabled our success.
Werewolf Therapeutics launches as publicly traded company
Werewolf Therapeutics, a biopharmaceutical company pioneering the development of therapeutics to stimulate the body’s immune …
The Intersection of Value and AI: Where Machines Can Make a Difference
Upcoming CCM panel discussion features experts from UPMC, Vanderbilt, NCQA, and Astrata on the future of artificial intelligence in health care