Hospitals and health systems - those managing risk in particular - should also approach MA via collaboration with:
Some payers have struggled with MA due to an administrative services approach, whereas its clients – employers – retain care management and risk responsibilities. Expect more payers to instead emulate UnitedHealthcare’s and Humana’s focus on innovation, nimbleness, and being more directly involved in managing care delivery.
What Providers need to do
Market Trend:
kai's View:
Next Trend:
Download 2019 Trends
Commercial payers
The Future of Physician Practice?
All signs point to Medicare Advantage’s (MA’s) continued expansion in 2019, as members of the baby boom generation gradually work their way up to a median age of 65. (They’re currently at 63.)
Boomers are attracted to the privatized managed care programs because of both familiarity with network-based plans and perks not offered under traditional Medicare, including gym memberships, dental and vision coverage, and consumer-friendly options like telemedicine and concierge care – not to mention capped out-of-pocket costs.
The result has been an explosion in coverage. MA’s penetration has doubled to 20 million beneficiaries since 2010. By 2025, that number is projected to double again. The two biggest behemoths to embrace MA are also seeing that move pay massive dividends. Humana recently cruised past Wall Street’s earnings estimates, largely on the strength of its MA success. The same was true for UnitedHealthcare stock as it hit a new record high.
What Providers need to do
The penetration numbers make Medicare Advantage all but impossible for payers and providers to disregard.
Download 2019 Trends
Medicare Advantage growth will continue to accelerate among payers and providers as more consumers demand it.
Provider-sponsored health plans with MA experience such as Presbyterian Healthcare Services' Fluent
What Payers need to do
The Future pf Physician Practice?
Next Trend:
Enablement partners like Lumeris, Bright Health, and Clover
Download 2019 Trends