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2018 ANNUAL ELECTION PERIOD: MEDICARE ADVANTAGE MARKET Issued: March 14, 2018
PAGE 2 | March 2018
TABLE OF CONTENTS EXECUTIVE SUMMARY ................................................................................................ 3
MEDICARE ADVANTAGE MARKET TRENDS ............................................................. 4
PLAN OFFERINGS ................................................................................................................................... 4
PENETRATION ........................................................................................................................................ 7
AEP COMPARISON ............................................................................................................................... 10
MA ENROLLMENT: PRODUCT TYPE ................................................................................................... 12
MA ENROLLMENT: PARENT ORGANIZATION .................................................................................... 14
DISCUSSION ................................................................................................................ 19
PAGE 3 | March 2018
EXECUTIVE SUMMARY
At a 34% nationwide penetration, just over one-third of all Medicare beneficiaries are currently enrolled in Medicare Advantage (MA) plans. The MA market has shown continued signs of stability. The 2018 Annual Election Period (AEP) saw a growth of 3.42% which is __% higher than the 2017 AEP. In addition, while the distinct count of parent organizations has remained relatively stable (4% growth over the 2018 AEP), the MA industry did see a 10% growth in distinct Plan Benefit Packages (PBPs). Gorman Health Group, LLC (GHG) believes the MA growth will continue to increase steadily for the foreseeable future. The growth in PBPs was predominately shared by Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs). Specifically, the total number of PPOs being offered nationwide grew 18% over this past AEP, while the total number of HMOs being offered grew 12%. With these facts in mind, there is an increased attentiveness by Medicare Advantage Organizations (MAOs) across the nation to develop product and benefit strategies that disrupt stable environments and continue to push growth. MAOs must understand the current landscape, growth trends, and what drives buyers and loyalty to grow in this environment. GHG has run an analysis of the MA marketplace to spotlight the current national enrollment and trends since 2013. The goal of the analysis is to highlight the stability of the MA market and to help MA health plans and industry professionals understand national and state trends that are impacting growth. With this understanding, in an effort to remain competitive, MAOs are forced to be more innovative in the products they provide and in the services they offer to members. Innovation is key. The analysis reviews national and state-level enrollment trends as of February 2018. Key findings include the following:
• Just over one-third of Medicare beneficiaries are enrolled in an MA plan. • MA enrollment continues to grow, but markets are relatively stable. • The distinct count of PBPs offered across the nation grew by 10% (mostly in the
individual market). • The majority of states have between 30 and 80 distinct PBPs being offered, with
an average of 12 individual PBPs offered by county. • Only 10 parent organizations own 67% of the individual MA market. • The 10 largest parent organizations are not the organizations experiencing the
most growth percentage in the 2018 AEP. • Over half (51%) of MA enrollees are enrolled in an HMO product.
PAGE 4 | March 2018
MEDICARE ADVANTAGE MARKET TRENDS
PLAN OFFERINGS
Before discussing enrollment, it is important to understand the trend of distinct plan offerings over time. As of February 1, 2018, there are over 3,300 MA plans (distinct PBPs) being offered nationwide of which roughly 300 are Employer Group Waiver Plans (EGWPs). The 2018 AEP saw the introduction of nearly 300 new MA PBPs, a 10% increase in distinct MA plans being offered across the nation, offered by a total of 285 parent organizations. This increase in distinct PBPs is significant because it indicates an increase in the competitive environment within the MA space. It is also important to note the majority of these additional plans are in the individual market. (Figure 1 & Figure 2)
249
265
277284 282
285
-2%-1%0%1%2%3%4%5%6%7%
230
240
250
260
270
280
290
2013 2014 2015 2016 2017 Feb-18
Figure 1: Total Distinct Count of Organizations Offering MA Plan, 2013-Feb 2018
Distinct Count of Parent Organization Growth Percentage
3,0763,011 2,986
3,0273,065
3,362
-2%-1%
1% 1%
10%
-4%
-2%
0%
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2,700
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2013 2014 2015 2016 2017 Feb-18
Figure 2: Total Distinct Count of MA Plans Available, 2013-Feb 2018
Distinct Count of PBPs Growth Percentage
PAGE 5 | March 2018
As seen in Figure 3, nearly half of MA plans (46%) are HMOs. Consistent with past years, the HMO product continues to grow. The 2018 AEP welcomed an additional 164 HMOs (13% increase). PPOs grew 22% this past AEP with an additional 101 new MA plans. The market also saw an increase in the number of HMO Special Needs Plans (SNPs) being offered: 25 new HMO SNPs. The HMO, PPO, and HMO SNP products account for 81% of the MA PBPs available in the market.
There is a wide range of total plan offerings by state with the most being in Florida, at a total of 302, and the least being in Alaska, which has no individual MA plan offerings (Alaska firms offer EGWP products). However, the majority of states have between 40 and 80 distinct individual MA plans being offered. Not surprisingly, the states with the highest count of MA plans are Florida, California, New York, Pennsylvania, and Texas, while those with the lowest (excluding Alaska and Hawaii) are found in the plains states of Wyoming (4), Montana (14), South Dakota (16), North Dakota (18), and Nebraska (21). This is expected, and as we will see further in this analysis, the count of plans by state correlates to total MA eligibles and penetration. (Figure 4)
941 1,004 1,058 1,157 1,220 1,384
526 502 455 449 461562471 464 463 469 484509
210 194 183 168 144149
103 114 123 126 130131
428 346 329 319 304302
0
500
1,000
1,500
2,000
2,500
3,000
3,500
2013 2014 2015 2016 2017 Feb-18
Figure 3: Individual MA Plans Available by Plan Type, 2013-Feb 2018
HMO PPO HMO SNP HMO-POS PACE Others
PAGE 6 | March 2018
Figure 4: Total Individual MA Plans per State, Feb 2018
As seen in Figure 5, the number of plans available to a single beneficiary has been relatively stable. To determine the average number of individual MA plans offered per county, GHG identified the total distinct number of MA plans by Federal Information Processing Standards (FIPS) numbers as found in the Centers for Medicare & Medicaid Services (CMS) enrollment and landscape files and took the average distinct count by year. In February 2018, the average beneficiary can choose among 12 MA plans. There is an average of 12 individual MA plans in each county nationwide. It is important to note, however, the distinct count of plans by FIPS codes ranges from 128 (Los Angeles County, California) to 1.
PAGE 7 | March 2018
PENETRATION
As seen in Figure 6, 34.5% of Medicare-eligible beneficiaries are enrolled in an MA, individual, or group plan. This accounts for over 21 million beneficiaries. Although we see annual growth, the 2018 AEP saw only a 1.32 growth percentage. Please note this growth is indicative of growth from December 2016 to February 2017 only. There will be enrollment shifts over the course of the year. Nonetheless, when looking at growth percentage from December 2014 to December 2015 and December 2015 to December 2016, we see smaller overall growth.
10.60 10.66 10.75
11.1811.42
12.46
1% 1%
4%
2%
9%
0%
1%
2%
3%
4%
5%
6%
7%
8%
9%
10%
9.50
10.00
10.50
11.00
11.50
12.00
12.50
13.00
2013 2014 2015 2016 2017 Feb-18
Figure 5: Average Individual MA Plans Offered Per County, 2013-Feb 2018
Average Distinct Count of PBPs Available Per County Growth Percentage
PAGE 8 | March 2018
Figure 7 shows the comparison of total individual and group enrollment. The 2018 AEP saw a 3.42% growth in the individual market (an additional 550,000 new Medicare enrollees) and 10.67% growth in the group market (an additional 395,000 new Medicare enrollees).
28.87%
30.79%31.43%
32.36%
33.38%
34.54%
2.96%
1.26%
5.72%
4.14%
1.32%
0.00%
1.00%
2.00%
3.00%
4.00%
5.00%
6.00%
7.00%
26%
27%
28%
29%
30%
31%
32%
33%
34%
35%
2013 2014 2015 2016 2017 Feb-18
Figure 6: MA National Penetration, 2013-Feb 2018
MA National Penetration Growth Percentage
12,288,99413,383,082
14,349,52915,192,784
16,129,080 16,680,450
2,597,570 3,004,869 3,168,294 3,213,526 3,701,662 4,096,746
8.90%7.22% 5.88% 6.16% 3.42%
16%
5%
1%
15%
5%
0.00%
2.00%
4.00%
6.00%
8.00%
10.00%
12.00%
14.00%
16.00%
18.00%
0
2,000,000
4,000,000
6,000,000
8,000,000
10,000,000
12,000,000
14,000,000
16,000,000
18,000,000
2013 2014 2015 2016 2017 Feb-18
Figure 7: Total Individual vs Group Enrollment, 2013-Feb 2018
Individual MA Group MA
Individual MA Growth Percentage Group Growth Percentage
PAGE 9 | March 2018
Figure 8 breaks down the overall 34.5% penetration as of February 2018 by state. Most states currently have 20-30% MA penetration (individual and group). The states with the highest penetration are Minnesota (56.83%), Hawaii (45.16%), Oregon (43.97%), Rhode Island (43.97), Florida (42.98%), California (41.7%), Pennsylvania (40.99%), Ohio (40.84%), Wisconsin (40.3%), and New York (39.34%). It is interesting to note that the majority of enrollment in Minnesota is in the Cost plan which will no longer be offered in most counties in 2019. GHG will be watching closely to understand how many cost plan members migrate to other MA plans or will enroll in Medicare Supplement plans. As seen historically, those states with the lowest penetration, with the exception of Vermont and Alaska, are clustered in the plains states regions (Wyoming, Nebraska, Kansas, Montana, North Dakota, Iowa, and South Dakota). As found in GHG’s 2016 “Medicare Supplement Market Trend Analysis,” there is an inverse relationship between MA and Medigap penetration. We learn when comparing findings of the Medigap analysis, those states with the lowest MA penetration are those with the highest Medigap penetration nationwide (Nebraska at 51%; Iowa at 49%; Kansas at 46%; Wyoming at 45%; South Dakota at 42%; North Dakota at 41%). (Appendix 2) Figure 8: MA Penetration by State, Feb 2018
PAGE 10 | March 2018
AEP COMPARISON
Figure 9 shows MA growth for the past five AEPs: 2014 AEP through 2018 AEP. Since the 2015 AEP, overall growth each AEP had been decreasing. The 2018 AEP is the first AEP in 3 years where the overall growth was higher than the prior year. Over the 2018 AEP, overall growth is marginally higher than the 2017 AEP. AEP growth remains relatively stable. As in the 2017 AEP, the ten largest MA parent organizations are UnitedHealth Group, Inc.; Humana, Inc.; Kaiser Foundation Health Plan, Inc.; Aetna, Inc.; Anthem, Inc.; Cigna, WellCare Health Plans, Inc.; Centene Corporation; Aware Integrated, Inc.; and Scan Health Plan. Table 1 below shows the 2018 AEP overall growth for the largest organizations. All the top parent organizations show a positive growth this past AEP with the exception of Cigna. These parent organizations all have large footprints with SCAN having the smallest footprint of the ten. United and Humana have the largest national footprint, offering coverage in 49 and 47 states/U.S. territories, respectively. SCAN offers MA coverage in 3 states.
Table 1: 2018 AEP Individual Enrollment Trend by Largest Parent Organizations
Parent Organization
Total Enrollees Dec 2017
Total Enrollees Feb 2018
2018 AEP Trend
2018 AEP Growth
Percentage
Feb 2018 Market Share
United 3,695,919 3,933,828 237,909 6% 24% Humana 2,852,333 2,986,451 134,118 5% 18% Kaiser 1,037,143 1,042,471 5,328 1% 6% Aetna 930,087 1,015,141 85,054 9% 6% Anthem 675,707 701,887 26,180 4% 4% Cigna 429,762 428,782 -980 -0.2% 3%
443,271
531,668
467,590 479,848
551,370
3.61% 3.97%
3.26% 3.16%
3.42%
0.00%
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4.50%
0
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2014 AEP 2015 AEP 2016 AEP 2017 AEP 2018 AEP
Figure 9: Nationwide AEP Comparison, 2014 AEP - 2018 AEP
AEP Trend Growth Percentage
PAGE 11 | March 2018
Table 1: 2018 AEP Individual Enrollment Trend by Largest Parent Organizations WellCare 373,139 378,531 5,392 1% 2% Centene 264,532 278,097 13,565 5% 2% Aware 260,475 269,280 8,805 3% 2% SCAN 182,777 189,016 6,239 3% 1% Total All Firms 16,129,080 16,680,450 551,370 3% 100%
When assessing the enrollment trend of the group MA market, we find the ten largest MA parent organizations differ from the individual market. The ten largest group MA parent organizations are UnitedHealth Group, Inc., Aetna, Inc., Kaiser Foundation Health Plan, Inc., Humana, Inc., Blue Cross Blue Shield of Michigan, Highmark Health, EmblemHealth, Inc., Horizon Healthcare Services, Inc., InnovaCare, Inc., and Henry Ford Health System. Table 2 below shows the 2018 AEP overall growth for the largest group parent organizations. Overall, the group MA market saw an increase in nearly 400,000 new enrollees.
Table 2: 2018 AEP Group Enrollment Trend by Largest Parent Organizations
Parent Organization
Total Enrollees Dec 2017
Total Enrollees Feb 2018
2018 AEP Trend
2018 AEP Growth
Percentage
Feb 2018 Market Share
United 1,152,960 1,295,535 142,575 12% 32% Aetna 547,618 706,285 158,667 29% 17% Kaiser 525,682 525,451 -231 -0.04% 13% Humana 428,240 482,784 54,544 13% 12% BCBS MI 318,675 372,605 53,930 17% 9% Highmark 87,059 86,991 -68 -0.1% 2% Emblem 66,144 65,766 -378 -1% 2% Horizon 56,803 56,866 63 0.1% 1% Innova 31,390 32,670 1,280 4% 1% Henry Ford 32,682 28,915 -3,767 -12% 1% Total All Firms 3,701,662 4,096,746 395,084 11% 100%
The largest parent organizations did not all exhibit the most growth this past AEP. Figure 10 shows the growth for those parent organizations that had the largest 2018 AEP growth. The organizations with the most overall growth in membership comprise 58% of the individual MA market. Figure 11 shows the growth for those parent organizations that experienced the largest percentage of growth in the 2018 AEP. Keep in mind, the organizations with the highest growth percentage this past AEP each have less than 1% in overall market share. UNICO Premier (0.01% market share) had the most growth percentage this past AEP with a growth of 521%. CHRISTUS Health Plan (0.01% market share) and HealthPartners UnityPoint Health (0.01% market share) show the second and third highest growth percentage this past AEP at 338% and 192%, respectively.
PAGE 12 | March 2018
MA ENROLLMENT: PRODUCT TYPE
With a total enrollment of 8.5 million enrollees, 51% of MA beneficiaries choose to enroll in an HMO plan type (Figure 11). HMO products continue to be the most popular product type among Medicare beneficiaries as seen by the overall market share but also by the growth this past AEP with an additional 360,000 new HMO MA members. PPO and HMO SNP product types saw the second and third largest growth over the 2018 AEP, adding
0
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1,000,000
1,500,000
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4,000,000
4,500,000
United Humana Aetna Anthem Centene Lifetime Universal MCS Aware Spectrum
Figure 10: 2018 AEP Growth by Parent Organization Largest 2018 AEP Growth Trend
Dec-17 Feb-18
+ 237,909
1,047966
4925,701
4749,279
426936
3,5982,684
0 1,000 2,000 3,000 4,000 5,000 6,000 7,000 8,000 9,000 10,000
2018 AEPGrowth Percentage
Figure 11: 2018 AEP Growth by Parent Organization with the Largest Percentage of Growth
University of Maryland Medical System Corporation Johns Hopkins Healthcare LLC
Stanford Health Care Select Founders, LLC
Universal Care, Inc Blue Cross Blue Shield of Nebraska
Louisiana Health Service & Indemnity Company HealthPartners UnityPoint Health, Inc.
CHRISTUS Health Plan UNICO Premier, LLC
+ 134,118
+ 85,054 + 26,180
+ 13,565 + 12,197 + 9,279 + 9,267 + 8,805 + 7,136
PAGE 13 | March 2018
219,900 and 36,600 new members, respectively. Refer to Table 3 below for a list of product types and their 2017 AEP growth trend and percentage.
Table 3: 2018 AEP Individual MA Enrollment Trend by Product Type
Product Type
Total Enrollees Dec 2017
Total Enrollees Feb 2018
2018 AEP Trend
2018 AEP Growth %
Market Share
Feb 2018 HMO 8,147,123 8,510,994 363,871 4% 51% PPO 2,359,446 2,579,443 219,997 9% 15% HMO SNP 2,087,554 2,124,201 36,647 2% 13% R-PPO 1,075,070 998,286 -76,784 -7% 6% HMO-POS 866,056 894,572 28,516 3% 5% Cost 569,410 569,410 541 0.1% 3% MMP 397,589 397,589 -20,681 -5% 2% R-PPO SNP 291,381 291,381 16,586 6% 2% PFFS 175,151 175,151 -24,927 -14% 1% PPO SNP 90,874 90,874 3,354 4% 1% PACE 39,206 39,206 408 1% 0.2% HMO-POS SNP 24,080 24,791 3,289 13% 0.2%
MSA 5,982 5,429 553 10% 0.04% Grand Total 16,129,080 16,680,450 551,370 3% 100%
HMO51%
PPO16%
HMO SNP13%
R-PPO6%
HMO-POS5%
Others9%
Figure 11: Distribution of Individual MA ENrollment, by Plan Type, Feb 2018
PAGE 14 | March 2018
MA ENROLLMENT: PARENT ORGANIZATION
Figure 12 shows the February 2018 market share by parent organization. As we have seen in the past, the industry giants of MA remain consistently the same. UnitedHealth Group and Humana alone hold 42% of the MA individual market.
Figure 13 shows the raw enrollment numbers of the five largest parent organizations from 2013 to February 2018. It is important to note these giants, while combatting an ever-stabilizing industry, have executed strategies that continue to push their membership upwards, with United adding nearly 240,000 new individual MA members over this past AEP. While smaller organizations, as we will see in the analysis, have experienced the most growth percentage in recent years as well as the 2018 AEP, the largest firms are still seeing notable growth. It will be important to assess product strategies and benefits within individual markets to understand what is driving significant growth.
United24%
Humana18%
Kaiser6%
Aetna6%
Anthem4%
CIGNA2%
WellCare2%
Centene2%
Aware2%
SCAN1%
Others33%
Figure 12: Individual MA Market Share, by Parent Organization, Feb 2018
PAGE 15 | March 2018
While United, Humana, Aetna, Kaiser, Aware, Anthem, and WellCare have each grown the most in overall enrollment since 2013, they are not the parent organizations that have experienced the most growth percentage. Figure 14 highlights the ten parent organizations that experienced the most growth percentage from 2013 to February 2018. These organizations are small, local organizations with less than 1% of the total MA market share, but their growth has been substantial. Clover has shown the most growth since 2013 at an overall growth percentage of over 10,992%. Medstar comes in second with an overall growth of nearly 6,668% (Table 4). These plans appear small in comparison to the giants in Figure 13, but their growth rate is important and should be noted. This is especially important when assessing their individual markets. To better understand what these plans have in common, a deeper dive into their markets and product offerings would need to be done.
2,862,000 2,766,889 2,806,5393,148,948
3,695,9193,933,828
2,030,115
2,415,597 2,743,1342,834,180 2,852,333 2,986,451
721,959 795,401 874,215 927,714 1,037,1431,042,471
339,166 433,793 550,965 765,137 930,0871,015,141
581,285 553,755 573,665 605,638 675,707701,887
0
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2013 2014 2015 2016 2017 Feb-18
Figure 13: Individual MA Enrollment Trend by Largest Parent Organizations, 2013-Feb 2018
United Humana Kaiser Aetna Anthem
PAGE 16 | March 2018
Table 4: Individual MA Enrollment Trend, by Parent Organizations with Highest Growth Percentage, 2013-Feb 2018
Parent Organization
Total Enrollees Dec 2013
Total Enrollees Feb 2018
Trend 2013-Feb
2018
Growth Percentage 2013-Feb
2018
Feb 2018 Market Share
Clover Health Holdings 276 30,615 30,339 10,992% 0.2%
Medstar Health 88 5,956 5,868 6,668% 0.04%
Caidan Enterprises 560 24,889 24,329 4,344% 0.1%
QHP Financial Group
124 4,205 4,081 3,291% 0.03%
CareSource Management Group
1,078 20,646 19,568 1,815% 0.1%
DLP Marquette General Hospital
331 4,841 4,510 1,362% 0.03%
Sentara Health Care 208 2,988 2,780 1,336% 0.02%
Ultimate Health Plan 544 6,767 6,223 1,143% 0.04%
Golden State Medicare Health Plan
801 9,636 8,835 1,103% 0.1%
0 5,000 10,000 15,000 20,000 25,000 30,000 35,000 40,000 45,000
Clover
Medstar
Caidan
QHP
CareSource
DLP Marquette
Sentara
Ultimate
Golden State
Intermountain
Figure 14: Individual MA Enrolment by Parent Organization with Highest Growth Percentage, 2013-Feb 2018
Feb-18 Dec-17 Dec-16 Dec-15 Dec-14 Dec-13
PAGE 17 | March 2018
Table 4: Individual MA Enrollment Trend, by Parent Organizations with Highest Growth Percentage, 2013-Feb 2018
Intermountain Health Care 4,586 40,195 35,705 776% 0.2%
Total All Organizations 12,288,994 16,680,450 4,391,456 35% 100%
While this analysis will not investigate the product detail of the largest and most-growth organizations, Table 5 below shows us one key element of the largest parent organizations is a diverse portfolio – they are hitting more markets by offering various product types and, even further, various plans within product types. Aware primarily offers large Cost plans in Minnesota. It will be interesting to see how their products expand as Cost plans terminate in over the next 2 years.
Parent Organization HMO PPO HMO
SNP R-PPO HMO-POS Cost MMP R-PPO
SNP PFFS PPO SNP
HMO-POS SNP
United 2,287,263 22,167 435,044 472,219 41,931 16,487 20,487 301,967 25,390 89,431 15,442
Humana 203,837 15,653 230,490 393,118 N/A N/A 7,907 N/A 90,014 N/A 307
Kaiser 912,553 N/A 81,878 N/A N/A 48,040 N/A N/A N/A N/A N/A Aetna 349,575 593,219 22,248 3,778 16,117 N/A 30,204 N/A N/A N/A N/A
Anthem 386,610 40,824 174,492 77,766 593 N/A 20,876 N/A N/A 343 383
Cigna 311,042 2,117 88,590 N/A 24,923 N/A 2,110 N/A N/A N/A N/A
WellCare 151,279 3,072 147,593 N/A 76,587 N/A N/A N/A N/A N/A N/A
Centene 167,404 36,268 24,634 N/A N/A N/A 49,791 N/A N/A N/A N/A
Aware N/A 38 8,419 N/A N/A 260,824 N/A N/A N/A N/A N/A
SCAN 165,028 N/A 22,542 N/A N/A N/A N/A N/A N/A N/A 1,446
Figures 15 and 16 showcase the total enrollment for the largest parent organizations and those organizations that experienced the highest growth percentage since 2013 by the largest product types (excludes Private Fee-for-Service (PFFS), PPO SNP, Programs of All-Inclusive Care for the Elderly (PACE), HMO Point of Service (HMO-POS) SNP, and Medicare Medical Savings Account (MSA) product types). Overwhelmingly, with the exception of Clover, the parent organizations with the highest growth percentage since 2013 are primarily in the HMO business.
PAGE 18 | March 2018
0
500,000
1,000,000
1,500,000
2,000,000
2,500,000
Figure 15: Individual MA Enrollment, by Product Type, by Largest Parent Organizations, Feb 2018
HMO PPO HMO SNP R-PPO HMO-POS Cost MMP R-PPO SNP
05000
1000015000200002500030000350004000045000
Figure 16: Individual MA Enrollment, by Product Type, by Parent Organizations with Highest Growth Percentage, 2013-Feb 2018
HMO PPO HMO SNP MMP PACE
PAGE 19 | March 2018
DISCUSSION
At a 34.5% nationwide penetration, just over one-third of all Medicare beneficiaries are currently enrolled in MA plans. Although growing annually, the MA market has shown continued signs of stability. There is an increased attentiveness by MAOs across the nation to developing strategies on how to thrive and progress in this stable environment. MAOs must understand the current landscape, growth trends, and what drives buyers and loyalty. As we saw with the comparison of products offered by the largest firms and the firms with the most growth since 2013, no market is created equal, and although the largest organizations offer a variety of products, those with the highest growth percentage are focusing on a few specific plan types, and they have found their service area “sweet spot” and are taking advantage of the opportunities. Additionally, trends reflect the big winners are providing innovation in the products they provide and in the services they offer to members. Organizations are advised to take the time now to analyze their respective markets to help position themselves for success in MA. Now is the time to ask yourselves, “What is driving growth in my market?” “What is detracting from my organization’s growth?” “What product and benefit differentiators will set my firm apart from the competition?” “Is my network sellable?” “Are my sales and marketing strategies meeting the needs of my market?” “Are my sales distribution channels properly aligned for growth in my market?” GHG recommends scrutinizing the following areas of your market:
• Market analysis (demographics, enrollment, benefits, market opportunity for various product types)
• Financial product feasibility study • Review retention strategies • Network analysis • Sales/marketing strategy return on investment (ROI) study
Next year will be an interesting one in that the OEP is back. Members in MA plans will have the opportunity to switch plans one time from January 1st to March 31st. MAOs will get a true understanding of how effective their member onboarding and member engagement strategies work.
