Survey: As Medicare population booms, MA plans eye growth opportunities

Business is booming in Medicare Advantage (MA), and many insurers operating in that market say they have plans to grow, according to a new survey. 

Software company HealthEdge backed a survey of 201 insurance executives who work with Medicare and MA plans and found that 92% were either growing or intended to grow their MA business more quickly than their traditional Medicare business lines. 

A clear draw is the steady growth in MA enrollment as more baby boomers age into Medicare. In 2019, 22 million people chose an MA plan over fee-for-service Medicare, about 34% of the total Medicare population, according to the survey. 

“It's going to become a super competitive market, where you don’t have to hit that big of a critical mass number,” Steve Krupa, CEO of HealthEdge, told FierceHealthcare. “If you have 10,000 to 20,000 members, you have a substantial revenue base.” 

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In addition to the swelling Medicare population offering a clear business case for favoring the MA market, the survey found MA insurers also highly value the opportunities for value-based care such plans provide. 

The vast majority (96%) said MA’s value-based options either significantly or moderately played a role in their decision to grow their business. 

In addition, 23% said they intended to optimize such programs, and 18% said they plan to design or refine high-performance networks or accountable care organizations, according to the survey.

“That’s perceived as a winner and a critical enabler for success,” Harry Merkin, vice president of marketing at HealthEdge, told FierceHealthcare.

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The biggest challenge MA plan sponsors face in these endeavors, though, is getting the necessary technology in place, the survey found. This is especially true as the people aging into Medicare are increasingly tech-savvy. 

The survey asked the participants to rank factors that would help them gear up for these new beneficiaries, and 40% named modernizing their technology tools as either the first or second choice. 

Some new plans “may even be looking at tech before they enroll their first member,” Krupa said. 

“People turning 65 today have been around for the smartphone revolution, the web revolution,” he said. "Really what we’re seeing is that you’re going to have a much more sophisticated technical user as people age in.”