The Academy Lumeris - Strategic Survey Q4 2018: Medicare Advantage

Key Findings

  1. Primary factors underlying increased provider participation in MA are the ability to provide improved benefits for patients at a reduced cost and consumer demand.
  2. Health systems include a variety of supplemental benefits in their MA plans, aimed at improving the satisfaction and overall health status of MA beneficiaries, which will ultimately lower the cost of care.
  3. Health systems are focused on improving consumer and physician engagement with in MA, offering additional resources and benefits for consumers and leveraging data analytics to assist providers in identifying gaps in care.

INTRODUCTION

As the healthcare industry continues to transition toward value-based care, health systems are prioritizing the implementation of risk-bearing models that control costs while improving the quality and coordination of care delivered. The Medicare population is a particular area of focus for provider organizations, as the country’s population ages and requires a higher volume of more complex services. Reflective of these trends, Medicare spending is projected to grow to 18% of total federal spending by 2028.1 Due to these pressures, many providers are looking toward Medicare Advantage (MA) to better manage this complex population. Leveraging MA’s expanded benefits and capitated payments allows providers to deliver coordinated care to their Medicare population while having greater control over the total cost.

In Q4 2018, The Health Management Academy (The Academy) conducted a qualitative assessment of health system executives around the current landscape and strategies for providers’ MA plans.

Methodology

In November 2018, The Academy conducted the seventeenth round of phone interviews for its quarterly strategic survey among Leading Health System executives, including: CEOs, COOs, CFOs, CMOs, CNOs, and CSOs.

The survey for the interview consisted of:

  1. A tracking section that provides insight into trends around primary strategic areas; and
  2. A special topic area that allows for an in-depth look into a timely developing issue.