2023 Outlook: MAOs Mull How to Compete While They Brace for Change, Uncertainty

In a sweeping proposed rule for the 2024 contract year, CMS last month took a strong stance on multiple aspects of the Medicare Advantage program, from misleading marketing and prior authorization to quality gains incentivized by the Star Ratings. As plans digest the many changes proposed in that rule, several major unknowns remain that could impact their revenue streams and ability to compete going forward. For our annual series of outlook stories on the year ahead, we asked a range of industry experts to weigh in on how doing business in 2023 might differ from previous years. Here’s the first installment on industry challenges and trends as told to AIS Health, a division of MMIT.

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• Radar on Medicare Advantage