Annual Election Period/AEP

Medicare Advantage Rolls Reflect 7% Year-Over-Year Growth, Slower 2023 Annual Election Period

Medicare Advantage enrollment is approaching 31 million lives as of February 2023, a 7.4% increase from this time last year, according to AIS Health’s analysis of data that included enrollment from the 2023 Medicare Annual Election Period (AEP). And while CMS says MA enrollment now represents about half of the total Medicare population, the rate of that growth seems to be slowing down — AIS’s analysis of the 2022 AEP recorded an 8.5% annual increase, and a 9.9% increase in 2021.


Seniors’ Plan Loyalty Wavers as Deft Saw 15% Medicare Advantage Switch Rate in 2023 AEP

Each year, Deft Research surveys a panel of Medicare beneficiaries to better understand consumer decision making during the Medicare Annual Election Period (AEP) and help carriers and their partners strategize for the next plan year. Deft’s 2023 Medicare Shopping and Switching Study, the latest in the firm’s Senior Market Insights Service series, features responses from more than 3,000 seniors who were surveyed immediately after the AEP and an additional 1,800 individuals who were surveyed regularly during the October-December period.

While the overall switching rate among seniors shopping during the AEP was relatively unchanged from prior years at 11%, Deft observed that switching by Medicare Advantage beneficiaries reached 15%, up from 12% seen in the prior two periods. That wasn’t surprising given that Deft’s AEP Gut Check Study from July 2022 suggested seniors’ frustration with plan-offered flex cards and interest in Part B giveback benefits might inspire them to shop around.


Humana Anticipates Strong EPS Growth in 2023, Cites Individual MA Enrollment Increase

During its fourth-quarter and full-year 2022 earnings call on Feb. 1, Humana Inc. said that it will have strong adjusted earnings per share (EPS) growth and see a significant increase in its individual Medicare Advantage (MA) enrollment this year.

Humana projects its adjusted EPS in 2023 will be at least $28, which “is slightly favorable to prior statements” and is 10.9% higher than its $25.24 adjusted EPS for 2022, Jefferies analyst David Windley wrote in a note to clients on Feb. 1.


AEP Wrap Up: Humana Vies for Industry-Leading Medicare Advantage Growth Position

After a lackluster 2022 open enrollment season characterized by churn associated with its external marketing channels, Humana Inc. is touting above-industry growth after the 2023 Annual Election Period (AEP) that concluded last month. Presenting at the 41st Annual J.P. Morgan (JPM) Healthcare Conference in San Francisco, Humana Chief Financial Officer Susan Diamond said investments in the company’s products, sales channels and other aspects of its Medicare Advantage business are helping it “get back to an industry leading position” and achieve double-digit percentage enrollment gains this year.

According to the latest monthly enrollment data posted by CMS, MA now enrolls more than 30.6 million individuals, including more than 25 million in individual MA plans. That data reflects enrollment as of the Jan. 1, 2023, payment date (i.e., enrollment accepted through Dec. 2, 2022). Those figures do not reflect the full outcome of the AEP, which ran from Oct. 15 through Dec. 7, and are lower than CMS’s projection of 31.8 million for 2023, pointed out Citi’s Jason Cassorla in a Jan. 17 investor note. “[W]e expect enrollment to rise in the final 5 days of AEP and subsequently grow throughout 2023 considering both age-ins” and the Open Enrollment Period that runs from Jan. 1 through March 31, he wrote.


Seniors Make the Switch to Medicare Advantage in Increasing Numbers

The number of seniors who switched from traditional Medicare to Medicare Advantage increased annually from 2016 to 2020, according to new research published in JAMA Health Forum. The switch rate from traditional Medicare to MA grew to 6.8% in 2020 — more than three times higher than the switch rate from MA to traditional Medicare. This trend was noticed across populations with a variety of traits, including age, race and mortality status, and was particularly strong among Medicare-Medicaid dual eligibles. Switch rates from MA to traditional Medicare, meanwhile, are largely on the decline, but still more common among duals than non-duals. The study’s authors suggested this movement was a contributor to overall MA growth, noting that MA’s share of Medicare enrollment is projected to exceed 50% this year. They also observed that switching accounted for a growing share of new MA enrollment growth, rising from 49% in 2016 to 67% in 2020.


Memory Fitness Offerings Jump 38% as MA Insurers Promote Mind-Body Wellness

Nearly three years ago, when insurers were in the early days of experimenting with new offerings under CMS’s reinterpretation of “primarily health related” supplemental benefits, very few plans were offering benefits specifically geared toward “memory fitness.” Now, a new Faegre Drinker analysis shows that these benefit offerings will be featured in more than 1,300 plan benefit packages (PBPs) next year — an increase of 38% over 2022.


MedPAC Mulls Concept of Standardizing Common Supplemental Benefits in MA

As Medicare Advantage insurers continue to grow their supplemental benefits offerings and CMS maintains a focus on improving the consumer experience, the Medicare Payment Advisory Commission (MedPAC) has begun work on the nascent concept of standardizing certain benefits in MA. During its Nov. 4 public meeting, the commission seemed mostly interested in standardizing a limited number of common supplemental benefits in the name of helping beneficiaries make better plan comparisons, but several commissioners expressed concern about potentially hampering MA plan innovation.


Senate Democrats Push for MA Marketing Fixes, but Not All May Be Feasible

After releasing the results of their multistate probe into the marketing practices of Medicare Advantage plans and their partners, Senate Finance Committee Democrats are urging CMS to enhance its oversight of MA marketing and issue “commonsense” regulations as soon as possible. The report, Deceptive Marketing Practices Flourish in Medicare Advantage, illustrated dozens of “aggressive marketing tactics” in 14 states and advised CMS to take various measures within its regulatory reach. But industry experts tell AIS Health, a division of MMIT, that not all recommendations may be doable in the near term. And they say it’s likely CMS will see how recent efforts fare before pursuing steps such as prohibiting MA organizations from contracting with entities that purchase lists of leads.


News Briefs: Health Insurance Call Center Workers Go on Strike

Workers employed by the federal contractor Maximus — which handles calls about Medicare and Affordable Care Act plans — went on strike in four states on Nov. 1. The employees based in Louisiana, Mississippi, Kentucky and Virginia want to be paid $25 per hour and have more breaks between calls, of which they field 15 to 20 daily lasting about 30 minutes each, NPR reported. Although the workers are not unionized, they had been organizing for months. In a statement to NPR, Maximus said it “welcomes the opportunity to work directly with our employees and discuss and hopefully resolve their concerns,” adding that it does not anticipate any service disruptions as a result of the strike. The Annual Election Period for Medicare Advantage plans began on Oct. 15 and the ACA open enrollment period started Nov. 1.


CMS Spooks MA Plans With Warning About Secret Shopping, Enhanced Monitoring

If Medicare Advantage organizations and Prescription Drug Plans (PDPs) this open enrollment season have the haunting feeling they’re being watched, it’s because they are. After implementing new rules aimed at better protecting beneficiaries from confusing and misleading Medicare marketing, CMS in October issued two memos informing plans that they’ve done some digging into recent marketing activities and they don’t like what they’ve seen so far.

CMS has reported that marketing-related complaints more than doubled between 2020 and 2021 — which it largely attributed to the actions of third-party marketing organizations (TPMOs) — and has expressed particular concern with third-party marketers’ claims that some benefits are widely available to seniors when they vary by service area. To address these concerns, CMS made key changes this year, such as requiring TPMOs to use a standardized disclaimer that they do not offer every plan available in the area, clarifying that independent agents and brokers qualify as TPMOs, and stipulating that plans in their contracts with TPMOs require full recordings of sales calls with beneficiaries.