Medicare Advantage Nears Milestone Growth Projection Says Cavulus CEO

Published: Jan. 11, 2022 at 12:30 PM CST

PITTSBURGH, Jan. 11, 2022 /PRNewswire/ -- Medicare Advantage (MA) may soon represent the majority of all Medicare membership according to Patrick Phillips, CEO of Cavulus, a leading provider of technology serving the Medicare Advantage industry.

Patrick Phillips, CEO Cavulus (PRNewsfoto/Cavulus)
Patrick Phillips, CEO Cavulus (PRNewsfoto/Cavulus)

Phillips foresees the 26 million current beneficiaries of Medicare Advantage eclipsing the 30 million mark this year as indicated by recent industry research. "That puts MA on the cusp of representing 50% of all Medicare coverage options -- a milestone our industry wasn't predicting until 2025," he said.

Despite continued challenges related to the on-going Covid pandemic, Phillips anticipates another significant growth year for the industry as the Annual Election Period (AEP) concluded a month ago, but enrollment figures won't be tallied until February.

The Cavulus CEO attributes MA's popularity to affordability, benefit richness, and the industry's adaptability to consumer preferences. "Medicare Advantage organizations (MAOs) are innovating and introducing new benefits but there's also responsiveness in the overall plan types being offered, he said."

Phillips cites new Kaiser Family Foundation data that shows "in 2022, over one-third of plans (37%) offered are local PPOs, compared to a quarter in 2018." Beyond that he pointed out that many beneficiaries want freedom to seek doctors and specialists outside of a defined network, noting that it's a necessity for snowbirds and people with second residences, which is driving demand for Preferred Provider Organizations (PPO).

Another example is the prevalence of Special Needs Plans or "SNPs" which are designed for beneficiaries in very narrow economic or health demographics. The Kaiser research reported that "more SNPs are available for 2022 than in any year since they were authorized".

Phillips has been particularly encouraged by the growth in chronic or C-SNPs created to serve members with conditions such as ESRD, diabetes, and cardiovascular disease, noting that "these MAO's organize highly specialized networks, services, and provide care support for these specific beneficiaries."

"There are 20 new entrants to the MA market for 2022, which is impressive" said Phillips. He views increased competition as the path to innovation, higher quality, and better outcomes.

ABOUT CAVULUS - Cavulus is a technology driven specialist in Medicare Advantage insurance solutions. Its cloud-based Medicare Advantage Platform (Cavulus MAP™) unifies marketing, sales and enrollment operations, and is utilized by many U.S. top insurers, including several BlueCross/ BlueShield companies, UPMC Health Plan, Johns Hopkins, Lumeris and United Healthcare. For details::

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