Where Medicare Advantage Goes From Here

MedCity News November 12, 2024
Bill Georges

Now is the time for health plans to step up and embrace the tools and strategies that will not only meet regulatory demands, but also drive innovation in care delivery.

With the election results now in, consensus thinking is that the new administration will be supportive of Medicare Advantage. But, don’t think for a second that CMS and Congress will deviate from their demands for more accountability and continuous improvement.

The industry broadly has failed to deliver on these two dimensions. That’s not my opinion — rather it’s embedded in the more stringent measures imposed by the industry’s regulators. Just look at the increased Star cutpoints and the v28 payment and reimbursement methodology. Oh and by the way,...

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