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Agents must understand these current trends as they prepare for the 2024/2025 MA Annual Enrollment Period (AEP). Let’s dive into the data and explore what it means for the future of MA.

Enrollment trends in 2024

MA plans have become increasingly popular, with about half of Medicare-eligible individuals enrolled. According to the Chartis report, the market has grown by 1.7 million beneficiaries since 2023, reaching a total enrollment of 33 million individuals. This represents a 5.4% increase over the previous year.

Special Needs Plans (SNPs) have experienced substantial growth, adding 1.2 million members in 2024—representing a 21.5% increase from the previous year. Nearly seven in 10 new MA enrollees opted for SNPs, with Chronic Condition SNPs (C-SNPs) leading the way. The increasing popularity of SNPs highlights the importance of catering to the unique needs of specific populations within the MA sector and presents a significant growth opportunity for health plans.

While the number of plan options remained relatively flat in 2024, with the average senior having access to 44 plans, the exponential growth trend in plan options observed in previous years has slowed down. Preferred Provider Organizations (PPOs) have seen an increase, constituting 43% of all plans offered, up from 31% in 2019.

As shown in the Chartis report, MA enrollment can be closely related to social vulnerability, with counties with higher vulnerability scores showing greater penetration rates. Quality ratings, however, have been a concern, as plans need help maintaining their average star ratings. About a quarter of beneficiaries are enrolled in plans with less than four stars, which could indicate a decline in quality performance in 2024.

Future market outlook and dynamics

Despite the challenges the MA market faces, plan executives remain optimistic about the future. A Chartis survey of industry leaders revealed that 84% expect their plan’s membership growth to be consistent or higher over the next year. While concerns about overall profitability, medical cost growth, and star quality reductions persist, the outlook for MA remains positive.

These trends will affect the upcoming 2024/2025 Medicare selling season. As the Annual Enrollment Period nears, and with the growth in MA enrollment slowing down, the competition among health plans during AEP may intensify. We’ll all need to carefully evaluate our strategies to attract and retain beneficiaries in a market that is becoming more saturated. 

Overall, 2024 MA enrollment trends provide valuable insights into the market’s current state and future trajectory. While growth has slowed since 2020, MA remains a preferred choice among Medicare-eligible beneficiaries. The increasing popularity of SNPs and the plateauing of plan options highlight the need for healthcare professionals to focus on sustainable growth, member engagement, and diversification strategies. As the MA market evolves, stakeholders must adapt strategies to navigate an increasingly complex and competitive landscape.

Takeaways

1. According to a recent report from Chartis, Medicare Advantage enrollment continues to grow despite mounting obstacles, with half of Medicare-eligible individuals now opting for these plans.
2. The report also demonstrated that Special Needs Plans (SNPs) are experiencing significant growth, particularly in the Chronic Condition SNPs (C-SNPs) segment.
3. Plan options have plateaued, and quality ratings remain a concern, emphasizing the need for sustainable growth strategies and member engagement efforts.
   
   

AEP Resources

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The Inflation Reduction Act, a significant piece of legislation, is poised to bring substantial changes to various sectors of the economy, including healthcare. For Medicare beneficiaries, this act promises to address several critical issues, potentially improving access to affordable healthcare and reducing out-of-pocket expenses.

Helpful CMS Resource: https://www.cms.gov/inflation-reduction-act-and-medicare 

Lower Prescription Drug Costs

One of the most impactful provisions of the Inflation Reduction Act is the reduction in prescription drug costs for Medicare beneficiaries. For years, seniors have struggled with the high costs of medications, which often force them to choose between essential medications and other necessities. The act aims to alleviate this burden by allowing Medicare to negotiate prices for certain high-cost drugs directly with pharmaceutical companies. This negotiation power is expected to lead to significant savings for beneficiaries.

Caps on Out-of-Pocket Expenses

The act introduces a cap on out-of-pocket expenses for prescription drugs under Medicare Part D. Starting in 2025, there will be a $2,000 annual cap on out-of-pocket spending. This is a monumental change, as it provides a clear limit to what seniors will have to pay each year for their medications, offering financial predictability and security.

Insulin Cost Reductions

For beneficiaries who rely on insulin, the Inflation Reduction Act brings particularly welcome news. The act caps insulin costs at $35 per month for Medicare beneficiaries, effective in 2023. This measure is crucial for the millions of seniors who manage diabetes, as it ensures they can afford this life-saving medication without facing financial hardship.

Expanding Subsidies

The act also extends the enhanced subsidies for low-income Medicare beneficiaries through 2024. These subsidies, initially expanded under the American Rescue Plan, help cover premiums and out-of-pocket costs, making healthcare more affordable for those with limited incomes. By continuing these subsidies, the Inflation Reduction Act ensures that vulnerable populations maintain access to necessary healthcare services.

Preventative Services and Vaccine Coverage

Preventative services and vaccines play a critical role in maintaining the health and well-being of seniors. The Inflation Reduction Act eliminates cost-sharing for adult vaccines covered under Medicare Part D, such as the shingles vaccine. Additionally, it improves access to other preventative services, encouraging beneficiaries to take advantage of screenings and early detection services without worrying about additional costs.

Addressing Health Disparities

The act includes provisions aimed at addressing health disparities among Medicare beneficiaries. By increasing funding for community health centers and expanding telehealth services, the act ensures that underserved populations have better access to healthcare. This focus on equity helps to close the gap in healthcare access and outcomes for minority and low-income seniors.

Conclusion

The Inflation Reduction Act represents a significant step forward in making healthcare more accessible and affordable for Medicare beneficiaries. By lowering prescription drug costs, capping out-of-pocket expenses, and expanding subsidies, the act provides much-needed financial relief to seniors. Additionally, its emphasis on preventative care and addressing health disparities ensures that all beneficiaries can enjoy better health outcomes. As these changes take effect, Medicare beneficiaries can look forward to a more secure and manageable healthcare experience.