By Lauren Kelly
CMS is expecting Medicare Advantage enrollment to grow by 11.5%
next year, with more than 36% of Medicare eligible consumers projected to be in
an MA plan in 2019. And plans are using improved payment rates and new benefit
design flexibility from CMS to sweeten the deal for customers, as evidenced in
the slew of press releases that have come out since Oct. 1, when marketing for
the 2019 Annual Election Period (AEP) began two weeks ahead of open enrollment.
“This was probably the first year in the past 15 that I have
seen 100% of our clients add benefits and not take them away in order to combat
health care trends,” says Jeff Fox, president of Gorman Health Group (GHG). “It
was a really good bid season with plans getting more creative, and I think the
ones that thought outside the box in terms of benefit design are going to see a
win here during the AEP.”
Many plans have said they were able to reduce premiums and/or
expand their $0 premium plan offerings for 2019, and will offer some
combination of dental, vision and hearing as a benefit. But Fox says the “heavy
hitters” for 2019 are over-the-counter (OTC) drug coverage and nutritional
benefits. “OTC is one of those few benefits that touches every beneficiary,” he
tells AIS Health. “It helps the healthy, it helps the unhealthy, and it helps
everybody who’s going into the store for those medicines the government doesn’t
cover.”
Meanwhile, several GHG clients that had tested offering
nutritional benefits on a small scale in 2018 and saw a return on their
investment expanded that offering in 2019, thanks to CMS broadening the scope
of health-related supplemental benefits that can be included in bids. “Health
plans have been doing certain things in care management programs, but they were
not able to advertise and market them,” says Fox. “So having [these benefits]
is going to be a huge success with members and I think it will play well from a
marketing perspective.”
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