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How Can Medicare Advantage Plans Gain Members in a Competitive Market?

11,000+ baby boomers turning 65 every day and become eligible for Medicare. The Centers for Medicare and Medicaid Services (CMS) predicts that Medicare enrollment will reach 72 million by 2025, and 99% of those beneficiaries have access to Medicare Advantage (MA) plans.

Medicare Advantage continues growing in popularity because it can achieve the triple aim of healthcare by keeping costs lower for patients, improving care while providing members with additional benefits that they value.

As the fastest-growing health insurance segment, MA presents more than $360 billion in market potential. So, it’s no surprise that according to an independent survey of health plan executives, 92% of health plans want to grow their MA membership more than other lines of business; and, 96% said the value-based model of MA significantly or moderately factors into that desire.

With 25% of Medicare beneficiaries having ten or more MA plans to choose from, health insurers need to keep pace and offer the most competitive benefits.

In an increasingly competitive market, how can health plans drive customer value and stand out?

According to HealthEdge Regulatory Compliance Manager Maggie Brown, “Baby Boomers are more digitally savvy than those who previously have aged into Medicare and Medicare Advantage plans. They want more information, and they want it now!”

Baby Boomers are looking for details about how to spend their dollars, which hospitals have better rankings or pricing, and which providers offer the best level of care.

Maggie continued, “The faster health plans embrace new legislation and regulations, the better off they will be, because even before a regulation mandates that health plans must provide a certain benefit to the Medicare population, Baby Boomers already want it.”

However, the majority of health plan executives say that technology and infrastructure that can’t keep up is the biggest challenge to staying compliant with CMS’s frequent changes.

Health plans need a core administrative platform that can easily create benefit plans and fee schedules to respond to constantly changing regulations and reimbursements. At the same time, the technology must enable the plan to maintain a quick turnaround time for processing claims with a high level of accuracy.