Oliver Wyman February 13, 2025
Health systems don’t have to flee Medicare Advantage. There is a path forward that can produce durable profit pools that rise with MA growth.
Enrollment in Medicare Advantage continues to soar. More than 33 million people are now covered by a Medicare Advantage plan, amounting to 54% of beneficiaries. While this growth is generally viewed as a positive, concern is mounting over program spending and potential waste. Medicare Advantage will account for 62% of Part A and B outlays in 2025, up from 38% in 2015.
A spate of regulatory actions over the past few years have been aimed at addressing this, ranging from a new risk adjustment model and tightening of Stars program rules to revamped reimbursement rates. These...
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