In 2023, Medicare Benefit (MA) plan members represented greater than half of all Medicare beneficiaries for the primary time. In 2024, as penetration continues, there are different developments inside MA that residence care suppliers ought to take note of.

Seniors have extra choices than ever when selecting MA plans. However a couple of of the highest corporations proceed to realize market share.

Notably UnitedHealth Group (NYSE: UNH), Humana Inc. (NYSE: HUM) and CVS Well being (NYSE: CVS) – by means of Aetna – proceed to outperform the competitors.

Final yr, UnitedHealthcare held 29% of the MA market with 8.9 million beneficiaries; Humana held 18% of the market with 5.5 million beneficiaries; and owned by CVS Well being

11% of the market with 3.3 million beneficiaries, in response to Kaiser Household Basis.

Blue Cross Blue Protect plans additionally owned a major share of the market, with 14% and 4.4 million beneficiaries.

Between 2023 and 2024, the largest plans continued to develop. UnitedHealthcare gained 478,000 new members, Humana added 412,000 new members and CVS Well being added 544,000 members, in response to a Chartis evaluation.

In the meantime, Elevance Well being's (NYSE: ELV) whole variety of beneficiaries fell by 25,000. Centene (NYSE: CNC) had an excellent greater decline, shedding 212,000 members.

Cigna (NYSE: CI) additionally agreed to promote its MA enterprise to Well being Care Service Company for $3.7 billion.

In keeping with Chartis, greater than 80% of the 1.7 million new MA beneficiaries went to revenue plans – similar to UnitedHealthcare, Humana and Aetna.

What’s outstanding in regards to the largest gamers within the MA discipline are their ambitions within the discipline of residence care.

UnitedHealth Group is straight concerned in residence care. It owns LHC Group and is within the strategy of buying Amedisys. These are two of the most important residence care organizations within the nation.

Humana owns CenterWell House Well being, additionally one of many nation's largest residence well being entities.

CVS Well being doesn’t straight own residence care sources, nevertheless it does personal Signify Well being, a house care enabler.

House well being suppliers have usually struggled to get honest charges from MA plans for residence well being care providers, regardless of a lot of their father or mother corporations searching for residence well being sources.

Different developments to think about

For residence care suppliers, the route of those plans with regards to extra advantages is value being attentive to.

“As with plan choices, the prevalence of supplemental advantages (which has elevated considerably lately) seems to be slowing and even declining for some advantages, suggesting that 'extra isn’t all the time higher,'” the Chartis authors wrote -analysis. “The proliferation of each plan choices and supplemental advantages is the driving pressure behind proposed laws from the Facilities for Medicare & Medicaid Providers relating to agent/dealer compensation, D-SNP integration, and supplemental profit reporting.”

Consultants within the discipline stay usually assured that using supplemental advantages – and notably the in-home assist providers that residence care suppliers assist handle – will maintain up. That's as a result of the plans that imagine in these advantages will proceed to lean on them at the same time as others drop the advantages to accommodate the speed cuts.

However CVS Well being CFO Tom Cowhey did acknowledge this week that some extra advantages might be on the chopping block.

“What are some issues we must be ?” Cowhey mentioned this on the forty fifth annual Raymond James Institutional Investor Convention. “I believe extra advantages must be on that checklist. I believe we – and possibly all the sector – must have a look at all the advantages throughout the board and determine the place to chop again. However I do know extra advantages will probably be a part of that dialog.”