Although a new report from The Commonwealth Fund raised concerns about the competition of Medicare Advantage (MA) programs available across the country, a new analysis from Avalere Health found that there has been a growing number of MA plan options for consumers.
Although a new report from The Commonwealth Fund raised concerns about the competition of Medicare Advantage (MA) programs available across the country, a new analysis from Avalere Health found that there has been a growing number of MA plan options for consumers.
Between 2012 and 2015, 28 organizations entered the MA market and currently offer plans to beneficiaries, with a total of 104 new plan options available in 24 states.
“As the baby boomers become Medicare-eligible, organizations across the healthcare landscape are stepping up to compete,” Dan Mendelson, CEO at Avalere, said in a statement. “In particular, health systems are playing an even larger role in the Medicare Advantage program, further blurring the lines between providers and payers.”
These new entrants to the market include established commercial plans, major health systems, and provider groups that have become health plans. Provider-owned plans represent more than half (54%) of the new MA entrants.
“In addition to Medicare Advantage, providers are becoming payers to compete on exchanges and serve employers,” said Elizabeth Carpenter, vice president at Avalere. “When combined with new start-ups and other options created by the Affordable Care Act, the insurance market looks increasingly diverse.”
Read the report: http://bit.ly/1OzR8sv
Trump Administration’s Message to Supreme Court Puts New Wrinkle in Braidwood Case
February 21st 2025The Trump administration argues that HHS Secretary Robert F. Kennedy Jr can overrule the US Preventive Services Task Force to determine the preventive services covered under the Affordable Care Act.
Read More
Varied Access: The Pharmacogenetic Testing Coverage Divide
February 18th 2025On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.
Listen
5 Key Health Care Moments During President Trump's First Month Back in Office
February 21st 2025President Donald J. Trump pushed for significant health care changes during his first month back in office, through executive orders affecting managed care, drug pricing, and clinical trial diversity guidance.
Read More
Same-Day Breast Imaging Gaps Reveal Health Care Disparities
February 18th 2025For this retrospective study, the authors examined data on more than 3 million screening mammographies for more than 1 million female patients; of the screenings, 23.6% had abnormal results and only 6.7% were recommended for biopsy.
Read More