Each Medicare Advantage (MA) plan has an associated “value added,” defined as the value of benefits provided to a specific plan’s beneficiaries above traditional Medicare that are not funded through member premiums. This report by Milliman actuaries Julia Friedman and Brett Swanson highlights key changes in beneficiary premiums and benefits for the 2018 MA market. The report also examines the reasons for, and the magnitude of, the decrease in value added within the MA market between 2014 and 2016 as well as the increases in value added in 2017 and 2018. The report aims to assist Medicare Advantage organizations in making strategic decisions during 2019 bid preparations.
Successful Medicare Advantage organizations maximize federal revenue to provide enhanced benefits and/or reduced premiums to their members, which ultimately improves marketability with the aim of increasing membership. Organizations entering the Medicare Advantage market should be aware of the current star rating climate as well as short- and long-term star rating and revenue considerations. This report by Milliman consultants provides perspective.
The Medicare Payment Advisory Commission (MedPAC) proposed several changes to the Medicare Part D program in a June 2016 report. MedPAC advises Congress on policies related to Medicare and its recommendations could potentially be enacted by Congress. This paper by Milliman’s Katie Holcomb and Julia Friedman discusses the impact that MedPAC’s proposed changes could have on plan sponsors, Part D members, and pharmaceutical manufacturers.
In this research report, Milliman’s Brett Swanson, Ari Kramer, and Julia Friedman highlight key changes in beneficiary premiums and benefits for the 2016 Medicare Advantage (MA) market as well as the reasons for and the magnitude of the decrease of value-add within the MA market between 2013 and 2016, with a more detailed look at changes between 2015 and 2016. It also summarizes the components of the Patient Protection and Affordable Care Act (ACA) and subsequent legislated actions driving the downward payments to Medicare Advantage organizations (MAOs). This report also aims to assist MAOs in making strategic decisions during 2017 bid preparations.