Logo

9. Is Medicare Advantage Collapsing After Its Boom Or Simply Adjusting

Millions of Americans feel confused and frustrated in their search for quality healthcare coverage.

Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change.

Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Podcast offers accessible, incisive deep dives on the most pressing issues and events in American healthcare.

Marc seeks to help Americans become wiser consumers and navigate the healthcare maze with more confidence and certainty through the Healthcare Labyrinth website.

Marc is an unconventional Republican who believes that affordable universal access is a wise and prudent investment. He recommends common-sense solutions to reform American healthcare.

Tune in every week as Marc examines the latest developments in the space, offering analysis, insights, and predictions on the changing state of healthcare in America.

On this episode of the Healthcare Labyrinth Podcast, Marc explains the context behind the recent bad financial news and decline in stock values for those insurers in Medicare Advantage.

Marc talks about the status of Medicare Advantage amid payment uncertainty, risk adjustment challenges, and new regulatory requirements.

Marc agrees that Medicare Advantage plans will need to reprice benefits and contract geographies at least in the short term.

Listen in to learn why the Medicare Advantage boom is over and what will happen in the MA industry.

Key Takeaways  

Medicare Advantage is in store for more rate uncertainty and risk adjustment formula changes

Some plans struggle with Star ratings, which means additional revenue issues.

Medical Utilization is increasing in Medicare Advantage due to utilization returning to normal and new prior authorization changes.

Bruce Broussard, CEO of Humana, predicted an entire industry repricing. 

Medicare Advantage will adjust, but continue since it is preferred over the traditional Medicare system.

Publicly traded plans may pull back on benefits to satisfy the investor demand for stronger margins.

Connect with Marc

Marc on LinkedIn

Marc on Twitter

THL Podcast

Resources

THL’s Newsfeed

THL’s Blog

The Healthcare Labyrinth: A Guide to Navigating Health Plans and Fixing American Health Insurance

Available Now

$30.00