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25 times. The amount of times “Medicare Advantage” was mentioned on the CVS Health earnings call today. 30 times. The amount of times the word “pressure(s)” was mentioned on the CVS Health earnings call today. 8 times. The amount of times the word “elevated” was mentioned related to costs or utilization on the CVS Health earnings call today. There has been a common theme during Q1 earnings across all highly concentrated Medicare Advantage public market payers; increased Medicare Advantage utilization and lower Star Ratings are resulting in extreme and material economic headwinds. Double digit decreases in operating income is directly attributed to these plans struggling with rising costs from care use in their Medicare Advantage book of business. With all the “headwind” talk and focus on “cost pressures” we all know the importance of Medicare Advantage and its ability to drive better outcomes for beneficiaries versus traditional Medicare. Karen S. Lynch alludes to this at the tail end of her opening remarks…. “Medicare Advantage will continue to deliver significant value to members, as well as better outcomes and patient experiences.” The time is now for Medicare Advantage plans to get creative and innovative with how they are engaging members, revamping benefit design and innovating their solutions. Medline Industries, LP Health Plan team is leaning into our clinical expertise and broad experience across the entire continuum of care to help our Medicare Advantage plan partners navigate these challenging times. #medicareadvantage #supplementalbenefits

The future of Medicare Advantage is here! 💡 Dive deep into the latest insights and strategies for navigating the shifting landscape. From demographic shifts to regulatory changes, learn how payers can stay ahead. Check out the article now: https://lnkd.in/d4sWZqhP #Healthcare #Medicare #HealthcareTrends #Automation #Droidal

Growth in Medicare Advantage has shown that a public market can privatize quickly, but there are reasons to be both bullish and bearish on the business line heading into the second half of 2024. This Guidehouse article lays out why leaders need an aligned health system and plan strategy to reap the benefits.

This year, health plans received more than $12 billion in Medicare Advantage (MA) quality bonus payments. These ratings, far from being mere indicators, serve as a benchmark for the quality, trust, and excellence that members expect from their MA plans. In the 2020 Star Ratings, member experience measures constituted only 31% of the total weight. This proportion is set to increase to 58% in the 2023 Star Ratings. For payor organizations, this challenging landscape requires a vastly improved member experience to differentiate themselves — every time. Member and patient experiences are now a top priority. Take a look at our latest blog post on modernizing your Stars program with the help of Qualtrics + Farlinium.

This past week, we added to the voluminous body of literature that demonstrates the value of comprehensive and continuous primary care to individuals and our health care system. The first, is the analysis of the Medicare Shared Savings Program (MSSP) that showed that physician-led ACOs with >75% primary care physician composition saved 2 times more that hospital-led ACOs. The second study, published in JAMA, found “a clear association of primary care visit patterns with cost savings and utilization outcomes, with the largest reductions in both risk-adjusted Medicare spending and acute care utilization seen among patients who received regular care with high continuity.” These studies are the latest to prove or more appropriately affirm a fundamental truth – investment in comprehensive and continuous primary care is good for individuals, good for communities and good for our health care system. Here are the links: https://lnkd.in/gn6bpADJ https://lnkd.in/g9jc2KUk

At the recent Health Plan Alliance Value Visit, sales and marketing leaders from community-based health plans shared transformative insights into the commercial and individual market segments. Here are key takeaways: 🔹 Medicare Advantage (MA) Growth: Despite losses in other areas, MA continues to thrive, now covering over 50% of Medicare members. Balancing growth with profitability amid regulatory changes remains crucial. 🔹 ACA Marketplace Stability: Regional plans are experiencing success and stability in the ACA Marketplace, driven by affordability and enrollment gains. 🔹 Small Group Market Volatility: Regional disparities demand data-driven approaches to improve small group margins, with ICHRAs emerging as a popular alternative. 🔹 Strategic Growth Approaches: Success stories highlighted the importance of partnerships, calculated market penetration, competitive pricing, and leveraging local community ties for differentiation. Connect with us and explore how we can help your health plan thrive. https://bit.ly/4b3Fiqo #HealthPlan #ACA #Medicare

Check out this insightful blog by Christian Bagge, VP of Payer Strategy at Get Well, on navigating the complexities of Medicare Advantage and proactively engaging MA Plan Members. Stay ahead of the curve and empower your members through education and communication. 🚀 Let's embrace change as an opportunity to better connect and support each other through uncertainty. 💜 #MedicareAdvantage #Healthcare https://lnkd.in/eWDjZEmC

Are you a CEO of a Medicare Care Advantage health plan? If so, I wonder how proud you would be to have an article like this written about you and your company? If it is a goal you want to achieve, it begins with an effective Consumer Engagement (CE) strategy. CE is defined as an "intentional, consistent approach by a company that provides value at every customer interaction, thus increasing loyalty." Building and implementing an effective CE program is not difficult or expensive and Zipari is here to help! With the Zipari Consumer Engagement Hub (CEH), health plans receive the technology to streamline outreach in a single, easy-to-use tool. It provides you with the ability to create and deliver personalized next-best-actions integrating seamlessly with your existing data sources and technology. It is easy to implement and it will fit in your budget. Not sure if Zipari is right for you? Zipari and its all of its products were build by payer industry experts specifically for the payer industry. Join the more than 150 payers who use Zipari today! PM me or visit us at www.zipari.com to learn more.

Cotiviti Senior Product Director Ashley McNairy explains how forward-thinking leaders can use the coming months to address methodology changes proactively and improve their success with the 2025–2026 ratings. Taking a proactive approach is essential for plans to address the evolving nature of the Star Ratings methodology. Read more in Integrated Healthcare Executive. https://bit.ly/3vEFgGD #HealthPlans #healthcare #payments

The financial pressures on healthcare payers in the US are intensifying as insurers respond to demographic shifts, regulatory changes and member preferences. In spite of the need to control costs, investment remains important to meet expectations for growth. Here are five key trends anticipated to emerge among payers navigating this complex landscape: https://bit.ly/3Vt89R0 #healthcare