What will Medicare Advantage plan look like in 2020? The healthcare industry has gone through significant changes and although the government’s role in the industry will not change, there are several new players poised to enter the fray.First of all, it appears that many of the private insurance companies have concluded that they can get better returns from managed care for their members than from traditional fee-for-service. More affordable premiums, more access to doctor and less bureaucracy are enticing features for them.
Medicare now requires all private-sector insurers to offer five essential health benefits (EHBs) and it also required the enrollees to select an insurer that offered the plan. The focus now is on developing a simpler, easier to understand program. Additionally, the government has told states that the five essential benefits should cover preventive care as well as basic hospitalization.As a result, Medicare Advantage plans will now not just be a choice between fee-for-service and managed care but also between fee-for-service and managed care. The focus is still on affordability, quality and access to physician services. These criteria are still in place, but the client does not need to know them all.
So, what’s the big deal? The government has just put forth new requirements that will result in more competition and lower costs so it makes sense that providers are looking at other ways to retain and attract clients.Medicare Advantage plans could become even more diverse as more organizations form. This means some flexibility with the coverage or even no plans at all if they feel there isn’t enough demand for their offerings.
Still, we may see an evolution of plans that provide extra services. The government said it wanted a program that would not only cover routine and preventative care but also “enhance” those services. This could mean additional doctor visits or even MRI services.Doctors will also be able to make recommendations or go above and beyond what Medicare will pay for as long as the service is medically necessary. Part of the new mandate is also about encouraging these providers to partner with one another, which could be a benefit to consumers and a boon to health management.
One of the problems faced by private insurance companies was that many of their providers did not want to take on the responsibility of meeting the government’s mandates. This might help them take on this increased demand.While many are aware of the small business exchanges, few of them are aware of the ongoing focus on creating an ever more complex program called Medicare Advantage Plans. In fact, the Medicare Advantage Plans was not always known as such; however, the program was developed with the goal of assisting seniors in meeting their health care needs with their preferred provider organizations. Obtain a Medicare Advantage plans in 2021
Of course, any changes in the rules and regulations involved in these new programs will affect business and it will take time for the full impact to be felt. Many of the insurance plans to offer these new offerings do not actually employ physicians or offer a direct relationship with them. As a result, some business models could be impacted and some may even be threatened. It’s too early to tell, but with these types of changes in the industry, one has to wonder what will happen to Medicare Advantage Plans in 2020.