Growing Bucket of MA-Enrolled Veterans Poses Star Ratings, Risk Score Conundrums
-
Apr 03, 2025
Medicare Advantage insurers are increasingly targeting their tailored, or “affinity,” plans toward veterans, hoping to attract this subgroup of veterans with benefits that wrap around their Veterans Administration (VA) care. Emerging research questions whether such plans are nothing more than profit-generating enrollment boosters, but industry experts say they present opportunities to improve care coordination for a vulnerable population. Those efforts are complicated, however, by gaps in enrollees’ medical records that also pose challenges when it comes to Star Ratings and risk adjustment, sources tell AIS Health, a division of MMIT.
While major MA plan sponsors like Humana Inc. and UnitedHealth Group dominate the veteran plan landscape, other smaller insurers have followed suit to differentiate themselves from their competitors while serving a potentially untapped market. Similar to other “flavors of plans” — like SCAN Health Plan’s Affirm plan for older LGBTQ+ adults or offerings catering to the Asian American and Pacific Islander population — these are the “veteran-flavored plans,” says Jenn Kerfoot, chief strategy and growth officer with DUOS and a former Navy hospital corpsman.
Read more
© 2024 MMIT
The Latest
Meet Our Reporters
Meet Our Reporters
GAIN THERAPEUTIC AREA-SPECIFIC INTEL TO DRIVE ACCESS FOR YOUR BRAND
Sign up for publications to get unmatched business intelligence delivered to your inbox.