Expert Insight

7 minute read

Can health plans turn their MA business around this year?

Rising utilization, stricter CMS oversight, and an aging population are compressing Medicare Advantage margins — forcing plans to pivot from growth to disciplined execution and stronger managed care.

The Medicare Advantage landscape is currently defined by rising care utilization among seniors and increasing regulatory oversight from CMS. These factors lead to increased medical costs and lower than expected payments for Medicare Advantage (MA) plans, pushing MA payer margins into negative territory and forcing insurers to make difficult choices about product design, benefit offerings, or (at the most extreme end of the spectrum) their participation in the MA market entirely.


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AFTER YOU READ THIS
  • You'll understand why MA has shifted from growth to execution.
  • You'll recognize how leading MA plans are redefining growth.
  • You'll see what MA plans must do to win in today’s and tomorrow’s MA environment.

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