As Insurers Unveil Expanded MA Offerings, CMS Touts Program’s Success

Hundreds of Medicare Advantage plans (MA) are expected to make use of newfound leeway given to them on supplemental benefits by federal policymakers earlier this year. That added elbow room includes potential opportunities for home care providers as well.

The Centers for Medicare & Medicaid Services (CMS) touted the growth and evolution of the MA program in an announcement issued last Friday.

In addition to touting Medicare Advantage’s overall success, CMS also pointed out key MA pricing trends, mainly noting that plan premiums, on average, are projected to drop in 2019.


“The steps that the Trump administration has taken to improve and drive competition in Medicare Advantage means more savings, more benefits, and lower costs for seniors,” CMS Administrator Seema Verma said in a statement. “The popularity of programs, such as Medicare Advantage, and with the various new supplemental benefits and policy changes that have been adopted, we expect plan choices to be even more robust moving forward.”

Overall, MA premium averages have steadily declined since 2015 from the actual average premium of $32.91. For 2019, the Medicare Advantage average monthly premium will decline by $1.81 to $28.00 from 2018, CMS estimates.

Roughly 83% of Medicare Advantage enrollees will have the same or lower premium in 2019 if they continue in the same plan, according to CMS.


While premiums are on their way down, MA enrollment is projected to reach a new all-time high, with more than 36% of Medicare beneficiaries expected to be enrolled next year. That’s about 22.6 million Medicare beneficiaries in total — and about 2.4 million more beneficiaries than in 2018.

Nationally, the number of MA plan choices will increase from about 3,100 in 2018 to about 3,700 in 2019.

Additionally, because of new flexibilities available for the first time in 2019, nearly 270 Medicare Advantage plans will be providing an estimated 1.5 million enrollees new types of supplemental benefits, including, for example, adult day care services and in-home caregiver support services.

“Medicare Part D and Medicare Advantage demonstrate the successes possible when we harness consumer choice and private-sector innovation to improve care and lower cost,” U.S. Health and Human Services Secretary Alex Azar said in a statement. “Efforts to strengthen negotiation and competition in Medicare Part D are bearing fruit in the form of lower drug costs for American seniors, a key priority for President Trump. Meanwhile, the significant steps taken to maximize competition among Medicare Advantage plans and support and empower Medicare beneficiaries are a crucial piece of allowing patients to define and drive value, which the Trump administration has made a priority.”

Home care providers having been paying close attention to how insurers capitalize on CMS’ decision to allow certain non-skilled in-home care supports under the MA program ever since the agency announced the move in April. Some insurers, including Indianapolis-based Anthem, Inc. (NYSE: ANTM), have started to roll out new benefits packages that make use of those new opportunities.

Amedisys (Nasdaq: AMED) CEO Paul Kusserow recently highlighted his company’s interest in forming MA partnerships during the 2018 Home Health Care News Summit in Chicago.

Access to other supplemental benefits, such as dental, vision, and hearing, continues to grow as well, according to CMS.

Similar growth in terms of enrollment and available plans is also expected in 2020.

Written by Robert Holly

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