Medicare Advantage Enrollment

Medicare Advantage Enrollment

A recently released regional analysis of Medicare Advantage growth is giving an early look at what happens to Medicare Advantage enrollment when markets become saturated and mature.

The western US was an early adopter of Medicare Advantage coverage and their enrollment rates have now consistently leveled out at around 40%. The other regions of the US aren’t at the 40% plateau yet and are still enjoying exponential growth, but if the west region data is any guide, their rate of growth too will level off in the next three years.

When that happens, growth will be limited to the “age-in” rate of the population—the only thing left will be cost-control. If this data is any guide, the shift will be rapid and catch most Medicare Advantage Organizations by surprise.

The investors fueling the growth in Medicare Advantage are not looking for revenue, they’re looking for accelerating revenue growth (ARG). Once enrollment levels off, once each additional covered life becomes more expensive to enroll, the “Great Premium Grab” will be over and the ARG will flatline. In search of the next opportunity, capital will flee, Medicare Advantage Organizations will be sold or shut down—and healthcare organizations who truly want to care for patients will be left holding the bag.

That’s the opportunity of a lifetime for you.

Abandoned by their former insurers, millions of patients are going to come to you seeking good care. If you can deliver it cost-effectively and with innovation, the bag you’ll be left holding will be overflowing with revenue.

Looking at the charts, this is going to begin happening nationwide by 2022. Now is the time to take steps to improve the systems that you use to control costs so you can be ready.

First, make sure your primes have skin in the game. Nothing else will be as effective as sharing risk and educating them about how their contracts work.

Then allow them to innovate cost controls. Since the feedback loop for their efforts will go right to their bottom line, it’ll focus their minds wonderfully on continuous improvement.

And when “peak Medicare Advantage” is reached you’ll be one of the few who’ll prosper.