Specialist
Medicare Expert & Adviser at Medicare Nation LLC
Agenda
- Medicare Advantage (MA) – data prevalence and plans across players
- Key players, value-based care strategies and speciality networks
- MA penetrations outlook into 2025
Questions
1.
What’s your take on key developments, trends and recent debates around Medicare? What should we be paying attention to?
2.
What are the further implications from CMS’s recent rate adjustment? What’s the potential flexibility vs the benefits and cost-sharing reductions to health plans? How do you see that panning out in the next few years?
3.
How is the competitive bidding process affecting the pricing for various healthcare segments? What changes do you expect in the benefits environment with patient recruitment?
4.
Could you walk us through the other categories within the supplemental benefit structure?
5.
Do you think the increasing medical loss ratio we’ve been seeing is a concern for insurance and global risk provider groups? Will there be more partnerships between payer and global risk providers going forward?
6.
Factoring in the prices paid for the physician groups – which have a relatively low EBIDTA – do you think it has become a must to own physician groups? Is it the best use of return on capital?
7.
When we look across players in Medicare Advantage, who do you think has done a better job in the partnerships, in the integration and actual value extraction?
8.
Could Humana catch up to a Blue Cross Blue Shield or an Aetna model in terms of being more effective in partnerships? Why do you think Humana’s doing poorly?
9.
Hypothetically across players, what do you think could ultimately halt or even stop the growth for Medicare Advantage?
10.
How do you think the increasing competition in the Medicare Advantage marketplace could ultimately impact pricing and where do you see that average premium growth being year to year?
11.
What are your thoughts on some of the newer entrants, such as Bright Health and Devoted? How do the new players stack up against the incumbents and the larger players? Which ones should we pay attention to?
12.
What is your view on M&A activity going forward, broadly across the traditional players?
13.
Is there anything you would like to further mention, maybe any catalysts in the next 12-18 months that we should keep an eye out for?
