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inforceReport | strategy-catalyst

Medicare Advantage Market Update: 5 Insights From the C-Suite

Related Topics:
Payer Strategy
Relevant Roles:
Chief Strategy Officers Chief Financial OfficersChief Physician Executives

Across H1 2024, the Strategy Catalyst team presented our MA research to Chief Strategy Officers, Chief Financial Officers, Vice Presidents of Finance, Chief Physician Executives, and Chief Revenue Cycle Officers and prompted discussions around how they are evaluating or rethinking their MA strategies. We published two pieces in response: the first reflects insights from these discussions (this publication), while the second overviews the market update we provided to these leaders.

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Preview of the Insights:

  1. There’s near-universal agreement amongst health systems that MA contract portfolio management must be more proactive.

  2. MA provider-sponsored health plans are a growing liability, yet often a key lever in payer negotiations.

  3. A lack of patient education is leaving patients in the dark about the realities of MA.

  4. Emerging fears about AI as an exacerbator of administrative waste usually outweigh excitement about its potential to streamline revenue cycle operations.

  5. Prior auth and supplemental benefits are the top areas to find solutions with payers.