Amidst falling profitability, declining margins, and persistent regulatory uncertainty, healthcare payers are aggressively looking for opportunities to sustain their business. With most of the large payers strategically prioritizing growth in the Medicare Advantage (MA) market, it is evident that they believe MA is one such opportunity to make profits, even in these uncertain market conditions.
Enrollment in Medicare Advantage plans has grown at a CAGR of 10.3% in the last 12 years. This staggering growth over a decade suggests that these plans have created immense value for both the payers and the beneficiaries. As in every business, payers and enrollees in the Medicare Advantage market segment are also facing some challenges. The future strategy of the stakeholders in this market will depend on a variety of factors including, but not limited to, government policies, ability to overcome the existing business challenges, and the continuously evolving market conditions.
To understand the factors that have led to the rise of Medicare Advantage in the healthcare payer industry, Everest Group looks at some basic questions such as:
What is Medicare Advantage and how is it different from Original Medicare?
Why has Medicare Advantage gained prominence in the healthcare payer ecosystem?
What are the benefits and challenges of Medicare Advantage for the payers?
What are the benefits and challenges of Medicare Advantage for the beneficiaries?
Which specific areas should the payers focus on to extract the maximum benefit out of the Medicare Advantage market?
What lies ahead for the Medicare Advantage market?
