Radar on Medicare Advantage

Although health care was a motivating factor for many voters in the 2018 midterm elections, the politicization of the COVID-19 pandemic and a lack of agreement within the Democratic and Republican parties on future health care reform has muddied the waters for candidates running in the 2020 general election, pundits observed during a recent panel at the America’s Health Insurance Plans (AHIP) National Conference on Medicare, Medicaid & Dual Eligibles. And the first presidential debate, which took place on Sept. 29, only further solidified the expectation that a large-scale overhaul of the health care system is unlikely under either candidate.

The first question of the on-air, in-person debate related to President Donald Trump’s plan to immediately replace late Justice Ruth Bader Ginsburg (see brief, p. 8), but things quickly exploded into a debate about the Affordable Care Act (ACA). Trump accused former Vice President Joe Biden and the Democratic Party of wanting “socialist medicine” and the elimination of private health care. Biden clarified that his proposal for a public option is “only for people who are so poor they qualify for Medicaid” and that his intent is to “expand Obamacare” and let people keep their private insurance.

A presidential election is a known disruptor to Medicare marketing campaigns, which for the 2021 Annual Election Period (AEP) began on Oct. 1, and insurers and their broker partners this election cycle face the dual challenge of also marketing during a pandemic. As a result, marketing experts advise carefully timing the various components (e.g., digital, mail, radio/television ads) of your campaign between now and the Dec. 7 end of the AEP to get the biggest bang for your buck.

“An election year doesn’t need to be scary,” says Renee Mezzanotte, executive vice president of client engagement with Chesterbrook, Pa.-based DMW Direct. “During past election years, we have found consumers are distracted and less likely to engage with some media channels in the days leading up to the election. Because of this, we collaborate closely with our clients to plan acquisition as well as member communication differently to ensure a successful AEP.”

With its annual release of the so-called landscape files for the Medicare Advantage and Part D programs, CMS on Sept. 24 estimated that enrollment in MA will jump 10% to an “all-time high” of 26.9 million beneficiaries, while the average monthly MA plan premium will drop 11% to an all-time low of $21.00. Meanwhile, beneficiaries shopping during the 2021 Medicare Annual Election Period (AEP) that starts Oct. 15 will be inundated with choices, from the sheer number of plans available to a plethora of supplemental benefits.

CMS, in its Sept. 24 press release accompanying the unveiling of the landscape files, estimated that MA beneficiaries will have an average number of 47 plan choices per county, up from about 39 in 2020 and 33 in 2019. The agency added that the number of plan options in rural counties next year will increase by about 18% to 2,900, “as a result of flexibilities we gave to plans on benefit coverage and building their provider networks.”

✦ The overall average scores for Medicare Advantage and Part D organizations subjected to 2019 program audits dropped from 1.03 in 2018 to 0.77, according to the 2019 Part C and Part D Program Audit and Enforcement Report. Published on Sept. 14, the same day as the early release of Part 1 of the Advance Notice (see story, p. 1), the Medicare Parts C and D Oversight and Enforcement Group (MOEG) estimated that CMS imposed a total of $1.6 million in civil monetary penalties on eight sponsors in 2019. That was the first year of the third audit and covered approximately 71% of MA and Part D enrollees. Compared with the 2018 program audits, sponsors showed the greatest improvements in the areas of Compliance Program Effectiveness and Medicare-Medicaid Plan Service Authorization Requests, Appeals and Grievances. The average number of conditions cited per audit in 2019 was 11, compared with 38 in 2012, observed MOEG. Visit https://go.cms.gov/2GXhPyN.

✦ Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) has partnered with health system Hackensack Meridian Health to offer a Medicare Advantage plan for 2021. The jointly operated plan, Braven Health, will also feature RWJBarnabas Health, subject to approval by the New Jersey Dept. of Banking and Insurance. It will offer MA plans in eight New Jersey counties with a “broad provider network anchored by Hackensack Meridian Health and that includes all health care professionals who participate in Horizon BCBSNJ’s managed care network,” according to a Sept. 14 press release. Visit www.bravenhealth.com.