CMS Expects a Stronger Medicare Advantage Market in 2019

Wednesday, November 28, 2018

Things are looking up for the Medicare Advantage market. According to new data from The Centers for Medicare & Medicaid Services (CMS), 2019 will consist of a significant rise in plan choices in counties across the nation. CMS anticipates that many new providers will enter the market, which subsequently can fuel a continued decrease in premium costs.

Medicare Advantage (MA) presently maintains a market penetration rate of 34.3%. Next year, CMS predicts this number will grow to just under 37%. Also being reported is that roughly 270 Medicare Advantage plans, will cover an estimated 1.5 million enrollees with new supplemental benefits. Due to expanding the definition of health-related supplemental benefits along with a focus on addressing social determinants of health, such offerings will include, but are not limited to, over-the-counter medication and product coverage, home and bathroom safety devices and modifications, adult day care services, in-home caregiver services, and reduced cost sharing programs.

If you’re doing the math at home, this increase means more options in most geographical areas. What was an average of 29 plan choices per county in 2018 will now jump to 34 per county next year. That means that over 91% of Medicare eligible individuals will have access to more than 10 Medicare Advantage plans in 2019. That’s pretty significant.

The reason for the growth isn’t only caused by new entrants and increased competition, though. Long-time Medicare Advantage Organization (MAOs) are also offering more in legacy service areas. Michael Adelberg, principal with FaegreBD Consulting and a former top CMS MA official, suggests “It will be especially interesting to see if the new benefit flexibilities coupled with elimination of the meaningful difference review resulted in MAOs offering more products in legacy service areas.”

We won’t know much more until next year. After all, most MA plans haven’t had enough time to operationalize new supplemental benefits for 2019. Considering that that’s the case, CMS expects 2020 to be even more wide open. Kirk Twiss of Clear View Solutions recently stated that “…there is a lot of interest, and CMS has said they’ll issue further guidance this year, so hopefully the guidance will be in place before the planning cycle starts for the 2020 benefits and bids."

Again, only time will tell. In the meantime, we can certainly anticipate a stronger Medicare Advantage market next year regardless.

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