June 2017 Newsletter

Understanding the next wave of Medicare Enrollees

Approximately 26 million baby boomers will age into Medicare through 2030. As they do, will health plans be ready to capture and retain them? Many researchers describe two groups within the Baby Boomer generation: “leading edge” and “trailing edge.” Trailing-edge Boomers are the next wave of Medicare enrollees, while leading-edge Boomers have mostly aged into the program already. While they might be more likely to select Medicare Advantage (MA) products, as they typically have extensive experience with employer coverage, networks, benefit designs, and health plans that offer MA products, health plans should consider how this next wave differs from the last in order to capture future Medicare market share. Read the Entire Article here.

Understanding Medicare Enrollees

CMS released a final notice detailing changes to how it calculates Medicare Advantage (MA) plan payments, as well as bigger-than-expected payment rate increases for 2018. Health insurance companies received a gift from the federal government last week. The 2018 Medicare Advantage rate policies included a better-than-expected pay bump and industry-friendly policies. Payment rates for insurers that sell Advantage plans will rise by 0.45% on average for 2018, the CMS announced. That’s a slight bump from the 0.25% rate increase proposed in February. The average payment rate will increase by 2.95% after taking into account the way health plans code their members’ diagnoses, the CMS said. Read the Entire Article here.

For the first time ever, less than half of physicians are independent

Less than half of practicing physicians in the U.S. owned their medical practice in 2016, marking the first time that the majority of physicians are not practice owners, according to a new study. Only 47.1% of physicians in 2016 had ownership stakes in a medical practice, an American Medical Association study released Wednesday found. That’s down from 53.2% in 2012, and research shows that doctors, especially young doctors, have been shifting from owning their own practice to joining larger practices. Read the Entire Article here.


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2017-08-15T17:24:34+00:00