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Cigna 2023 Medicare Certification Details

Posted by www.psmbrokerage.com Admin on Thu, Jun 02, 2022 @ 04:17 PM

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Cigna Eliminates Most Medicare Advantage, IND Cost-Sharing Through 2020

Posted by www.psmbrokerage.com Admin on Fri, Jun 05, 2020 @ 10:34 AM

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Medicare Advantage Outperforms Traditional Medicare

Posted by www.psmbrokerage.com Admin on Thu, Mar 12, 2020 @ 08:57 AM

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Cigna Names New Medicare Advantage Executive

Posted by www.psmbrokerage.com Admin on Fri, Mar 06, 2020 @ 10:38 AM

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Cigna Starts 3 Strategic Partnerships

Posted by www.psmbrokerage.com Admin on Mon, Feb 10, 2020 @ 02:31 PM

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The Mad Rush To Sell Private Medicare Plans To Seniors

Posted by www.psmbrokerage.com Admin on Thu, Oct 10, 2019 @ 04:13 PM

The Mad Rush to Sell Private Medicare Plans to Seniors

The Mad Rush To Sell Private Medicare Plans To Seniors

Health insurers across the U.S. will race to enroll more seniors in lucrative government-backed Medicare plans this month, even as a roiling debate over the role of private companies in health coverage shapes the presidential race.

The plans, known as Medicare Advantage, are the private-sector, taxpayer-financed alternative to traditional Medicare. Selling them has become a crucial profit center for the insurance industry: Baby Boomers are aging into the program, propelling its growth, while at the same time health insurance products sold to people under 65 are facing pressure from all sides.

The private plans also sit squarely in the middle of the race for the presidency: Some candidates for the Democratic nomination, including Senators Bernie Sanders and Elizabeth Warren, have backed a proposal to do away with private health insurance across all markets. Last week, President Donald Trump signed an executive order aimed at bolstering Medicare Advantage, and said Democrats would upend the program.

In 2019, about 22 million people, or roughly a third of all Medicare enrollees, got their Medicare coverage through the private plans. For each person who signs up, the insurers collect a fee from the government. It was $11,545 on average this year, which adds up to about $254 billion. The Medicare Advantage enrollment period opens Oct. 15.

Insurers see it as a lucrative market they can’t afford to pass by. Medicare products are the biggest business at the biggest health insurance company, UnitedHealth Group Inc.’s insurance unit. Centene Corp. agreed to pay $15 billion this year for WellCare Health Plans Inc. in part to get access to the company’s large Medicare business. Startups like Clover Health, which has raised more than $900 million from investors including GV, Alphabet Inc.’s venture capital arm, are targeting Medicare customers with new technologies intended to deliver care more efficiently.

UnitedHealthcare will sell Medicare coverage in 100 new counties in 2020, reaching 90% of the eligible market. Humana Inc., which specializes in Medicare Advantage, will expand to 29 new counties. Humana Chief Executive Officer Bruce Broussard told investors in July that membership was growing at the fastest pace in a decade, and the company expects to add half a million members this year. Cigna Corp., which has a comparatively smaller Medicare business, is expanding to 37 new counties next year and projecting 10% to 15% average annual membership growth through 2025. CVS Health Corp.'s Aetna unit is expanding to 264 new counties in 2020.

Medicare is especially critical to insurers as their traditional business selling health plans to employers and individuals slows. A smaller percentage of the U.S. workforce is enrolled in employer coverage than two decades ago, according to data from the Kaiser Family Foundation, a nonprofit health research group, as the cost of those benefits rises faster than workers’ earnings.

“We all know that 11,000 Americans turn age 65 every day and then the percent of those that choose” Medicare Advantage is accelerating, Anthem Inc. Chief Financial Officer John Gallina said at a conference in June. He called it “a huge opportunity that we’ve missed in the past, that we now need to capitalize on.”

Anthem’s Medicare Advantage membership grew by 25% in the 12 months ending June 2019, far faster than any other category. Anthem is expanding to 77 new counties in 2020.

Seniors in traditional Medicare can go to any doctor or hospital that participates, as most do. Those who choose Medicare Advantage plans trade that freedom of choice for an insurance company’s more limited network. In exchange, they get extra benefits. Medicare Advantage policies often wrap in prescription-drug plans, vision and dental care. Many offer free gym memberships or fitness programs. They also cap members’ total out-of-pocket costs. In traditional Medicare, seniors have to buy policies known as Medicare supplement or Medigap plans to limit their out-of-pocket expenses.

Starting in 2019, a federal rule change permitted Medicare Advantage plans to offer other perks like transportation and meal delivery. The goal is to address so-called social determinants of health, the many non-medical aspects of people’s lives that affect their well-being. Plans will offer a greater variety of those benefits in 2020.

Some Cigna plans in Texas will pay for air conditioners for the first time next year. Anthem will offer pest-control services, because vermin can affect chronic health conditions such as asthma. Carriers are also testing benefits like adult day care; home safety improvements, like grab bars, to prevent falls; and in-home help for people who need assistance bathing or dressing.

“We actually find a lot of beneficiaries are living in environments that really need support and help,” said Martin Esquivel, vice president of Medicare product management at Anthem.

Medicare doesn’t provide those things in its traditional fee-for-service program, partly because of the risk of inappropriate payments or fraud. In Medicare Advantage, the government’s payment to plans is limited, so that risk is managed by the plans.

The growth of Medicare Advantage shows demand for private managed-care plans exists even when seniors have a purely public option. “No one’s forcing them to do this,” said Dan Mendelson, founder of consultant Avalere Health and a partner at private equity firm Welsh Carson Anderson & Stowe. Seniors are increasingly comfortable giving up some choice of doctors in exchange for Medicare Advantage’s perks, he said. “It’s the choice that makes it really remarkable, that seniors are choosing this.”

While two-thirds of Medicare enrollees choose to stick with the original program, that share is declining. Mendelson said Medicare Advantage enrollment has grown by 8% annually in recent years. At that pace, more than half of Medicare members will be in private plans by 2025, he estimates.

Many people can get Medicare Advantage for no additional premium beyond what they pay for traditional Medicare. The average monthly premium for Medicare Advantage is $23 in 2020, down from $26.87 the prior year, according to the Centers for Medicare and Medicaid Services. It’s at the lowest level since 2007.

Plans have historically been paid generously. A decade ago, Medicare paid private plans 14% more than it would have spent for the same beneficiaries in the traditional program, according to the Medicare Payment Advisory Commission, known as MedPAC, which counsels Congress on Medicare policy. That helped finance additional benefits that enrollees found attractive, but it raised the program’s costs and put little pressure on plans to deliver more efficient care. The 2010 Affordable Care Act lowered those payments. They’re now about 1% above traditional Medicare payments, according to MedPAC.

People who choose to enroll in Medicare Advantage plans also typically have lower health spending before they enroll, compared with similar people in traditional Medicare, according to an analysis by the Kaiser Family Foundation. That means the way payments are set “may systematically overestimate expected costs of Medicare Advantage enrollees,” the Kaiser researchers wrote. Plans have been also faulted by government watchdogs for improperly denying care.

Medicare Advantage plans pay about 86% of their premium revenue out in medical claims, a similar proportion to other health insurance products, according to a separate Kaiser Family Foundation report. But the opportunity to profit is higher. Partly because Medicare beneficiaries use more medical care than younger people, there’s more money at stake for each member. Gross margins in Medicare Advantage – the difference between premiums collected and claims paid, before counting administrative costs – are about $1,600 per enrollee, roughly double the value in commercial plans, according to Kaiser’s analysis.

“This appears to be a fairly profitable market,” said Tricia Neuman, director of the Kaiser Family Foundation’s program on Medicare policy. The group sees more carriers enter the market than exit each year. “If it weren’t profitable, they wouldn’t be doing it,” Neuman said.

Big Winners
The market for Medicare Advantage plans has become increasingly concentrated. In 2018, the top four Medicare organizations had 59% of enrollment, up from 46% in 2011, according to MedPAC. And while it may seem like an attractive market, it’s difficult for new competitors to enter.

“We had no idea how hard it would be, how long it would take, the infrastructure we’d have to develop,” said Vivek Garipalli, chief executive officer of Clover Health. The company has about 42,000 members, mostly in New Jersey.

Other new technology-focused insurers are trying to break into the market. Oscar Health announced its first Medicare plans this year. Startup Devoted Health, which is led by former Obama administration officials, raised $360 million to launch its Medicare Advantage plans in 2019.

Those companies are betting that technology can deliver better care more efficiently, by using data to help physicians manage patients with chronic conditions, for example. Medicare Advantage is an ideal proving ground to test that idea, because plans make money if they can deliver savings without compromising quality.

“Health care has effectively had zero productivity gains over the last 20 years,” said Bob Kocher, a partner at venture firm Venrock. The firm backed Devoted Health and Kocher served as the company’s chief medical officer for a year. “There should be a lot of pent-up opportunity here to apply technology to make health care much more productive, and that would also make health care more affordable.”

--With assistance from Hannah Recht.

This article was provided by Bloomberg News.

Source: https://www.fa-mag.com/news/the-mad-rush-to-sell-private-medicare-plans-to-seniors-52068.html

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Tags: Humana, Cigna, Medicare Advantage, aetna

Cigna tees up largest MA expansion ever for 2020 plan year

Posted by www.psmbrokerage.com Admin on Wed, Oct 02, 2019 @ 10:59 AM

Cigna tees up largest MA expansion ever for 2020 plan year-1

Cigna is launching its largest Medicare Advantage (MA) expansion to date for 2020, including new geographic regions, products and benefits targeting the social determinants of health.

With MA open enrollment set to begin Oct. 15, Cigna announced it will launch its first MA PPO plans in 43 counties across eight states. It will also offer its existing HMO plans in 37 additional counties in nine states.

The insurer said it will make both plans available in the Denver area, its first foray into the state with MA.

In total, Cigna’s 2020 MA geographic footprint will include 80 counties across 17 states. Brian Evanko, president of Cigna’s government business, told FierceHealthcare growth in MA is a key element of the insurers’ long-term plans for growth.

“It’s a big step in that direction,” Evanko said.

Evanko said that Cigna’s broad geographic reach in other business sectors offers plenty of room for its MA footprint to grow. There are plan offerings in each market with a $0 premium, and 89% of 2020 plans offer a $0 copay on primary care visits, Cigna said.

Alongside the expanded plan offerings, Cigna announced that it will be testing new supplemental benefits targeting the social determinants of health for 2020. The Centers for Medicare & Medicaid Services finalized a rule earlier this year that allows MA plans to offer coverage for benefits targeting chronic care management, such as air quality tools for members with asthma.

Evanko said Cigna has in the past offered coverage for transportation and meals across business lines, finding success with, for example, a program that offered 14 days of meals after hospital discharge.

For 2020, Cigna will pilot an air conditioner allowance in some of its Texas plans, a fall prevention program for some Mississippi and Kansas beneficiaries, adult day care in New Jersey and will offer a patient attendant for medical visits in some Pennsylvania and Maryland plans.

In addition, Cigna intends to offer an acupuncture allowance in all its HMO plans and its PPO plans in Colorado and will test an expanded transportation benefit with some beneficiaries in Pennsylvania and Arizona that would include rides to the grocery store, church services and other nonmedical trips in addition to doctor visits and other rides for healthcare needs.

Evanko said the insurer selects supplemental benefit options based on member feedback and uses tests in certain markets as a barometer for benefits that may be beneficial to a broader group of members.

Some pilots build on existing offerings—such as the new transportation benefit, which also plays into ongoing work at Cigna to combat patient loneliness.

“We do this on a market by market basis to get the learning before we extrapolate it,” he said.

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Industry Updates: Medicare Supplement Market Premium Grows 4.9% to $32.4 Billion

Posted by www.psmbrokerage.com Admin on Tue, May 07, 2019 @ 04:04 PM

CSG Actuarial Blog Header

By Taylor McDonald – CSG Actuarial – May 7, 2019

CSG Actuarial, with information from the NAIC and other sources, reports total earned premiums in the Medicare Supplement market in 2018 totaled $32.4 billion, a 4.9% increase over 2017. The total Med Supp lives covered in 2018 increased to 14.05 million, up 3.9% from 2017. The top 12 carriers in terms of 2018 Medicare Supplement premiums were:

1 United Healthcare
2 Mutual of Omaha
3 Anthem
4 HCSC
5 CVS Health
6 Cigna
7 CNO Financial
8 BCBS of Massachusetts
9 Humana
10 Wellmark
11 BCBS of Michigan
12 BCBS of Florida

The 2018 overall Med Supp market loss ratio of 79.0% reflects a continued trend in the market of the overall loss ratios creeping back up towards “Pre-Modernized” levels of around 80%.

Source: https://www.csgactuarial.com/2019/05/industry-updates-medicare-supplement-market-premium-grows-4-9-to-32-4-billion/

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Tags: Humana, Cigna, Medicare, Medicare Supplement, CSG Actuarial, aetna, mutual of omaha

Walgreens Partnership Boosts Humana's Medicare Enrollment

Posted by www.psmbrokerage.com Admin on Mon, Feb 11, 2019 @ 10:49 AM

Walgreens Partnership Boosts Humana's Medicare Enrollment

By Bruce Jepsen – Forbes – February 7, 2019

Humana says its joint venture with Walgreens Boots Alliance is helping boost enrollment in Medicare Advantage, the fast-growing privately administered health coverage for U.S. seniors.

Humana reported a 9% increase in Medicare Advantage membership the health insurer attributed to physicians at more than 230 clinics including two sites inside Walgreens stores. It’s the latest sign showing the early stages of a joint venture between Humana and the nation’s largest drugstore chain is working and could be expanded beyond a pilot in the Kansas City market.

"Our 233 owned, joint ventured and alliance clinics, the majority of which are payer agnostic, including our two 'Partners in Primary Care' clinics inside Walgreens stores experienced positive results in the annual election period," Humana CEO Bruce Broussard told analysts Wednesday during the company's fourth quarter earnings call. "Humana MA membership grew over 9% in these clinics in the (annual election period) excluding the more mature Conviva clinics."

Humana, which has invested hundreds of millions of dollars acquiring and partnering with medical care providers in recent years, said its relationships helped it take Medicare Advantage market share away from rival insurers. Humana said it expects 2019 individual Medicare Advantage membership growth of “375,000 to 400,000 members, representing 12% to 13% growth,” the insurer reported Wednesday as part of its fourth-quarter 2018 earnings release.

Walgreens and Humana last year opened “senior-focused primary care clinics” inside drugstores as a way to complement Walgreens pharmacy services and Humana’s Partners in Primary Care centers that opened last year in Kansas City. The effort is designed in part to keep people out of the more expensive hospital setting and make sure Medicare patients have their care more closely monitored by Walgreens pharmacists and physicians in Humana’s health plan networks.

The two companies think they can do a better job of reaching patients who visit Walgreens retail locations and making sure they get better care upfront before they get sick. When the partnership was announced, Walgreens and Humana called it “a senior-focused neighborhood approach to health that brings together primary care, pharmacy, in-person health plan support and other services for Medicare beneficiaries.”

The Medicare Advantage growth is key for Humana, which is in a competitive battle with rival insurers like Aetna, UnitedHealth Group and Cigna, looking to tap into a market of more than 10,000 baby boomers aging into the Medicare population every day.

Medicare Advantage plans contract with the federal government to provide extra benefits and services to seniors, such as disease management and nurse help hotlines, with some even providing vision and dental care and wellness programs. CMS is changing regulations to allow Medicare Advantage plans to provide broader coverage in the future, which is also expected to boost enrollment. L.E.K. Consulting has projected Medicare Advantage enrollment will rise to 38 million, or 50% market penetration by the end of 2025.

Humana ended 2018 with 3.06 million individual Medicare Advantage members, which was up 7% from 2.86 million as of Dec. 31, 2017.

Source: https://www.forbes.com/sites/brucejapsen/2019/02/07/humana-walgreens-clinic-venture-boosts-medicare-enrollment/#1ce9cb783f39

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Tags: Humana, Cigna, Medicare Advantage, Medicare, aetna, Walgreens

Cigna Plans Broader Medicare Advantage Offerings

Posted by www.psmbrokerage.com Admin on Wed, Jan 16, 2019 @ 09:31 AM

Cigna Plans Broader Medicare Advantage Offerings By Bruce Jepson – Forbes* – January 10, 2019* Fresh from the completion of the Express Scripts acquisition, Cigna CEO David Cordani plans to broaden the insurer’s offerings to more seniors choosing Medicare Advantage plans as part of a major business expansion in coming years. Cigna’s disclosure this week at the JPMorgan Healthcare Conference comes as the insurer and its rivals including Aetna, Anthem, Humana and UnitedHealth Group are expanding into new geographic regions to sell more Medicare Advantage products. All of these insurers are taking advantage of a market of more than 10,000 baby boomers aging into the Medicare population every day. “We are well positioned today and going forward for existing and new markets,” Cordani said of future MA offerings. “Today, Cigna focuses on the individual, not the group M.A. marketplace. The group M.A. marketplace presents a future growth opportunity for us.” Cigna has more than 435,000 Medicare Advantage enrollees, which is far fewer than UnitedHealth, Aetna and Humana. But Cigna and an increasing number of other insurers see a bigger opportunity as the Centers for Medicare & Medicaid Services changes rules allowing health plans to provide richer benefit packages to attract more seniors to Medicare Advantage plans. Cigna is also looking to offer new less restrictive health plans that allow seniors more choices outside of health plan networks by introducing preferred provider organization (PPO) plans for Medicare Advantage enrollees. Unlike PPOs, HMOs restrict doctor choices to their networks. Cordani didn’t disclose a timetable for the PPO offerings. “Today, Cigna participates largely in the individual HMO portion of the marketplace, not the individual PPO part of the marketplace,” Cordani said. “That presents additional growth opportunity for us as we go forward, but that growth is built off of the success of the individual HMO market.” Medicare Advantage plans contract with the federal government to provide extra benefits and services to seniors, such as disease management and nurse help hotlines with some even providing vision and dental care and wellness programs. There are now more than 22 million Americans enrolled in privately-administered Medicare Advantage plans for 2019 with the number expected to continue to rise. Medicare Advantage enrollment will rise to 38 million, or 50% market penetration by the end of 2025, according to a report from L.E.K. Consulting. Cigna also sees an opportunity as Medicare moves to value-based payment models and away from traditional fee-for-service reimbursement that has been shown to lead to unnecessary tests and procedures due to its emphasis on volume of care delivered. Cordani said 85% of Cigna's Medicare Advantage “customers are in aligned value-based relationships.” “Those are very important in terms of how our model works: hand in glove with high-performing physician organizations and integrated hospital systems for the benefit of our M.A. customers,” Cordani said. https://www.forbes.com/sites/brucejapsen/2019/01/10/cigna-plans-broader-medicare-advantage-offerings/#74cdd59a44f5
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Tags: Cigna

Medicare Blog | Medicare News | Medicare Information

Cigna 2023 Medicare Certification Details

Cigna Eliminates Most Medicare Advantage, IND Cost-Sharing Through 2020

Medicare Advantage Outperforms Traditional Medicare

Cigna Names New Medicare Advantage Executive

Cigna Starts 3 Strategic Partnerships

The Mad Rush To Sell Private Medicare Plans To Seniors

Cigna tees up largest MA expansion ever for 2020 plan year

Industry Updates: Medicare Supplement Market Premium Grows 4.9% to $32.4 Billion

Walgreens Partnership Boosts Humana's Medicare Enrollment

Cigna Plans Broader Medicare Advantage Offerings

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