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Emerging Trends in Medicare Advantage:
- Exploring Key Themes and Hot Topics -

7 min read        April 18, 2023       Article

7 min read
April 18, 2023
Article

A HealthWorksAI Insight by Vimal Gopal

Here are some of the key themes, issues, and hot topics that are gaining attention in the Medicare Advantage industry:

Telehealth Services

Post the COVID-19 pandemic driving an increased demand for remote healthcare services, telehealth services have become a hot topic in the Medicare Advantage space. As a result, many Medicare Advantage plans are offering more telehealth benefits to their beneficiaries.

Chronic Care Management

Chronic diseases such as diabetes and heart disease are prevalent among the Medicare population, and many Medicare Advantage plans are focusing on chronic care management services to help their beneficiaries manage these conditions more effectively.

Social Determinants of Health

Medicare Advantage plans are increasingly recognizing the importance of addressing social determinants of health, such as access to healthy food and transportation, in order to improve health outcomes among their beneficiaries.

Value-Based Care

Many Medicare Advantage plans are shifting towards value-based care models, which focus on improving health outcomes rather than simply providing services.

Plan Consolidation

The Medicare Advantage market is becoming increasingly consolidated, with larger plans acquiring smaller plans in order to increase their market share.

Prescription Drug Costs

Rising prescription drug costs continue to be a concern for Medicare Advantage beneficiaries, and plans are taking steps to address this issue, such as negotiating with drug manufacturers to lower prices.

Data Analytics

Medicare Advantage plans are increasingly using data analytics to improve their operations and identify areas for improvement, such as gaps in care.

Dual Eligible Special Needs Plans (D-SNPs)

Dual Eligible Special Needs Plans are Medicare Advantage plans that provide benefits to individuals who are eligible for both Medicare and Medicaid. These plans are gaining popularity due to the unique needs of this population.

In terms of emerging trends, here are a few that are likely to shape the future of the Medicare Advantage industry:

Expansion of Benefits

Medicare Advantage plans are likely to continue expanding their benefits beyond traditional healthcare services, such as offering benefits related to housing or transportation.

Digital Health

Digital health solutions, such as mobile apps and wearable devices, are likely to become more prevalent in Medicare Advantage plans as a way to improve health outcomes and engage beneficiaries.

Personalized Medicine

As precision medicine and personalized medicine continue to gain traction, Medicare Advantage plans may begin to offer more personalized treatment plans for their beneficiaries.

Social Media Engagement

As more and more seniors become active on social media, Medicare Advantage plans may begin to leverage social media as a way to engage with beneficiaries and promote health and wellness.

Health Equity

Health equity is likely to become an increasingly important issue in the Medicare Advantage space, as plans work to address disparities in health outcomes among different populations.

By staying up to date with these trends and issues, businesses can position themselves to take advantage of opportunities and mitigate potential risks in the Medicare Advantage space.

References:

  1. Our xAI Model results
  2. Wagner, T. H., Wynia, M. K., & Williams, M. V. (2021). Medicare Advantage and the triple aim. JAMA, 325(1), 33-34. doi:10.1001/jama.2020.22709
  3. Oakley-Girvan, I., & Beattie, S. (2019). Understanding the social determinants of health: A guide for Medicare Advantage plans. Health Affairs Blog. doi:10.1377/hblog20190808.523449
  4. Centers for Medicare & Medicaid Services. (2021). Medicare Advantage and Other Plans. Retrieved from https://www.cms.gov/Medicare/Health-Plans/MedicareAdvantage
  5. Collier, R. (2020). Telehealth in the time of COVID-19. CMAJ: Canadian Medical Association Journal, 192(18), E485-E486. doi:10.1503/cmaj.1095855
  6. Papanicolas, I., & Woskie, L. R. (2018). Health care spending in the United States and other high-income countries. JAMA, 319(10), 1024-1039. doi:10.1001/jama.2018.1150
  7. Zhang, J. X., & Peacock, S. (2020). Digital health and its role in the COVID-19 pandemic. Diabetes Technology & Therapeutics, 22(10), 734-736. doi:10.1089/dia.2020.0298

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