Annual Election Period/AEP

Expanded Footprints, Enhanced Benefits Aided Plans’ OEP Gains

Medicare Advantage enrollment reached nearly 28.8 million as of May, reflecting an overall increase of about 1% during the three-month Open Enrollment Period (OEP) that ended on March 31, according to the latest update to AIS’s Directory of Health Plans (DHP). That’s compared with growth of 5.3% from October 2021 to February, reflecting results from the Annual Election Period (AEP) that ran from Oct. 15 through Dec. 7. Beneficiaries who enrolled in an MA plan during the AEP have a one-time opportunity to change their coverage selection during the OEP, and insurers that made above-average membership gains during both periods attributed their successes to product enhancements, geographic expansions and strong distribution partnerships.

Plan Finder Update Leaves Out Detail on Supplemental Benefits

As CMS continues to seek ways to improve its consumer-facing tools for comparing Medicare coverage options, the agency last month unveiled a series of tweaks to the Medicare.gov website and Medicare Plan Finder (MPF). The MPF in 2019 underwent a major makeover that reportedly cost the Trump administration $11 million but critics say fell short of fixing many of the issues highlighted in a July 2019 report from the Government Accountability Office. CMS has continued to make updates based on consumer feedback, but some industry experts suggest more detail around the supplemental benefits offered by Medicare Advantage plans would be useful.

“CMS is making Medicare.gov easier to use and more helpful for people seeking to understand their Medicare coverage, which is an essential part of staying healthy,” said CMS Administrator Chiquita Brooks-LaSure in a May 18 press release. “We are committed to listening to the people we serve as we design and deliver new, personalized online resources and expanded customer support options for people with Medicare coverage and those who support them.”

Segmented, Personalized Outreach Drives MAO Retention Efforts

Medicare consumers are facing an overwhelming variety of resources and plan choices and are showing signs of increased movement during the Open Enrollment Period (OEP). As a result, effective member engagement during the OEP and throughout the year is becoming increasingly important and can be achieved through using data to segment membership and deliver targeted, personalized messaging to ensure that a member is in the right plan from the start, industry experts advised during the 13th Annual Medicare Market Innovations Forum, hosted by Strategic Solutions Network, LLC (SSN).

After the Medicare Annual Election Period (AEP) that typically runs from Oct. 15 through Dec. 7, the three-month Medicare OEP starts on Jan. 1 and allows beneficiaries who selected a Medicare Advantage plan to make a onetime coverage change. This year was the fourth OEP since it was reinstated by the Trump administration after a hiatus, and seniors’ utilization of the renewed opportunity is growing.

PHE Extension, Medicare AEP Boost ’22 Earnings Projections

Better-than-expected first-quarter 2022 earnings aided by Medicare open enrollment successes and the extension of the public health emergency (PHE) drove several insurers at press time to raise their earnings guidance for the year. Some, however, approached their projections with caution as variant-driven surges in the COVID-19 pandemic continue to create uncertainty around utilization.

Reporting first-quarter earnings on April 27, Humana Inc. said its results from the latest Medicare Annual Election Period (AEP) were slightly better than projected and it is making progress on a $1 billion value creation plan unveiled last quarter that will allow the company to further enhance its Medicare offerings. For the AEP that ended Dec. 7, improvements were “driven by higher sales and improved voluntary termination rates,” explained President and CEO Bruce Broussard during an April 27 conference call to discuss recent quarterly earnings. Broussard also provided a detailed update on Humana’s efforts to improve the sales experience through its various distribution channels.

Average ACA Benchmark Plan Premium Continues to Drop in 2022

The national average premium for the second-lowest-cost silver plan, or benchmark plan, sold through the Affordable Care Act exchanges is $438 per month in 2022, a 1.8% drop compared to 2021, according to an Urban Institute analysis. Average benchmark premiums, by state, ranged from $309 in New Hampshire to $766 in West Virginia. The premium variation was associated with the type and number of insurers participating in a region. The presence of a Medicaid insurer led to lower benchmark premiums. In 2021, the benchmark premium in a rating region with only one insurer was $189.5 higher per month than in regions with five or more insurers.

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UnitedHealth Delivers Strong 1Q, Touts MA, Value-Based Growth

Despite variations in care utilization due to COVID-19 that drove up medical costs early in the quarter, UnitedHealth Group reported a strong start to 2022, with financial results exceeding analysts’ expectations driven by outperformance in both the UnitedHealthcare and Optum Health segments. As the company anticipates continued growth in value-based care initiatives and Medicare Advantage enrollment throughout the year, it raised its full-year adjusted earnings-per-share (EPS) outlook by 90 cents to a range of $21.20 to $21.70.

For the three months ending on March 31, the company recorded overall revenues of $80.1 billion, representing a year-over-year increase of 14.2% that reflected double-digit growth at both Optum and UnitedHealthcare. The UnitedHealthcare segment reported $62.6 billion in revenues, up 13.6% from $55.1 billion a year ago, and operating earnings of $3.8 billion, compared with $4.1 billion last year, reflecting the effects of “pandemic-disrupted care patterns,” the company explained in its earnings press release. Revenue for the Medicare & Retirement segment was $29.1 billion, up from nearly $25.5 billion in the first quarter of 2021.

With AEP Switching Low, MAOs Must Monitor Member Experience

Medicare beneficiaries have more plan choices than ever before, in addition to a dizzying array of supplemental benefits and increased PPO options, but plan switching has stalled, according to a new study from Deft Research. That leaves Medicare Advantage plans to consider whether low switching is largely due to members feeling satisfied with their current coverage or overwhelmed with the sheer amount of information being presented to them, observed industry experts during a recent webinar hosted by Rebellis Group LLC. As a result, members’ experience during the Annual Election Period may warrant a closer look as plans think about their strategy for the next AEP.

In its 2022 Medicare Shopping and Switching Study, Deft observed an overall switching rate of 11% during the most recent AEP. That’s compared with 12% seen in 2021 and 23% in 2015, reported George Dippel, executive vice president with Deft, during the March 10 webinar, “With more choices than ever, how will your Medicare Advantage plan stand out in 2023?” The annual survey featured responses from 3,389 Medicare enrollees, including 1,846 seniors who were enrolled in a Medicare Advantage plan in 2021 and 1,183 seniors with Medicare Supplemental (MedSupp) coverage. The remaining 360 respondents had Original Medicare only (OMO).

Geographic Expansions Assisted 2022 AEP Winners’ Major Gains

Medicare Advantage membership has grown by 8.5% since February 2021 to top 28.6 million lives, according to AIS Health’s analysis of data that included enrollment during the 2022 Annual Election Period (AEP). While nearly two-thirds of all new enrollees selected a plan from market leaders UnitedHealthcare, Humana Inc. or CVS Health Corp.’s Aetna, several regional insurers performed well above average, driven largely by service area expansions, provider pacts and benefit enhancements. (Per AIS’s research methodology, the following figures do not include lives enrolled in CMS’s Financial Alignment Initiative demonstration plans serving about 451,000 Medicare-Medicaid dual eligibles or participants in Programs of All-Inclusive Care for the Elderly.)

Medicare Advantage Enrollment Tops 28 Million in 2022 Annual Election Period

Approximately 2.2 million people enrolled in a Medicare Advantage plan from February 2021 to February 2022, bringing the total MA population to 28.6 million medical lives. That’s an 8.5% year-over-year increase, according to AIS Health’s analysis of data that included enrollment from the 2022 Medicare Annual Election Period (AEP), down from 9.9% growth during the prior-year period. Nearly two-thirds (64.3%) of all new enrollees selected a plan from UnitedHealthcare, Humana Inc. or CVS Health Corp.’s Aetna, while Centene Corp.’s major market expansion paid off, garnering more than 30% enrollment growth for the insurer. Meanwhile, Florida Blue parent GuideWell Mutual Holding Corp.’s completed acquisition of Triple-S Management Corp., one of the largest MA insurers in Puerto Rico, allowed it to crack the top 10 for the first time. Anthem, Inc. also completed a Puerto Rico MA deal with its July 2021 acquisition of MMM Holdings from InnovaCare Health. On the state level, four states saw MA growth of more than 20% (vs. 10 last year), including Delaware and Vermont, which have historically low penetration rates.

News Briefs: America’s Physician Groups and Others Are Urging CMS Not to Cancel GPDC Model

America’s Physician Groups (APG) and other stakeholders at press time were urging the Biden administration not to cancel the Global and Professional Direct Contracting (GPDC) model. The model, in which provider groups and other entities share risk and receive capitated payments for serving fee-for-service (FFS) Medicare beneficiaries, formally launched in April 2021 and has drawn interest from Medicare Advantage organizations. Although CMS put a pause on new applicants for the 2022 performance year, progressive lawmakers have asked the administration to stop it out of concern that private entities are seeking to funnel FFS enrollees into managed care without their knowing. In a sign-on letter to HHS Secretary Xavier Becerra, APG and other groups suggested that instead of canceling the model, the administration should limit participation to provider-led entities and “place additional guardrails and add more beneficiary protections.”