From Dr. Tom's Desk
Trends in new industry studies suggest a massive expansion in Medicare Advantage is in the offing. Can you take advantage of the opportunity?
The results of yet another huge study touting the benefits of Medicare Advantage were splashed across the healthcare media this past week. For examples, see here, here, and here. Read more about the details of the study and what lessons you can glean for your practice in “You Should Know” below.
The study is pretty standard as these industry-sponsored efforts go, and mostly with the results you’d expect. On the surface it looks like yet another of those observational studies that found cost savings associated with Medicare Advantage coverage.
Battlefield preparation for the upcoming open enrollment period---but perhaps something more.
A close reading in the context of our times suggests deeper trends, trends that you can profit from if you get ahead of them.
- The recent report of the Medicare trustees emphasized concerns regarding the sustainability of the Medicare program, even more so than normal for them.
- Increasing numbers of insiders scrambling to position themselves on the boards of Medicare Advantage Organizations and their supporting entities.
- The release of more and more studies such as the one we’re discussing today. They’re increasing in number and size, each trying to outdo the previous one in the appearance of “good” design based on “good” data. The emphasis on cost savings and improved outcomes continue to grow, as does and emphasis on the benefits for the underserved.
I’ve been watching these trends for years, and up until recently I believed that the increase in “research-based marketing” was simply the result of industry growth.
I no longer believe it’s just that. Things are coming to a head.
There will almost certainly be big push for a massive expansion in the Medicare Advantage program in the next Congress. It will probably take the form of even broader leeway in benefit design for insurers---leeway that will include greater opportunities for beneficiaries to financially benefit. It will be an expansion that will put traditional Medicare at a big disadvantage.
One year from today, look to the space to check the accuracy of this prediction. I suspect I’ll be writing about it much sooner.
And don’t be surprised if a prominent politician, one with strong ”anti-government healthcare“ credentials, embraces a “Nixon going to China” opportunity and goes all in for “Medicare Advantage for All.” They’ll endorse supplanting the current patchwork insurance system, including Medicaid, with a national Medicare Advantage model.
You read it here first.
Real universal healthcare---using a model that rewards innovation.
There are all sorts of implications but overall, that’s an opportunity where everyone can win.
And you don’t have to be one of the huge incumbent insurers to do so---you just have to be ready to scale when the race begins.