Medicare open enrollment closes, setting new record of 65M enrollees

Another record-setting, complicated, and confusing Medicare open enrollment period closed this week with more than 65 million Americans having to choose between Medicare or more than 40 different Medicare Advantage options.

The competition among supplemental benefit programs has become extreme, with private Medicare Advantage organizations battling for attention on television, print, mailers, and web-based advertising platforms featuring aging celebrities and pro sports figures promising everything from free groceries, valet services, no deductibles, free premiums, and heavily discounted prescription drugs. It is estimated that more than half of all enrollees in Medicare will have chosen a private-sector Advantage program by next year.

Despite recent audits and federal investigations that revealed major health care companies have wrongfully exploited the Advantage programs to boost profits, they remain popular with the public and some experts say the consumers are benefitting from the competition.

“The benefit competition gives us is twofold,” said Vincent Giglierano, senior manager of health services research at Faegre Drinker Biddle & Reath, the Minneapolis-based law, consulting and lobbying firm. “The first benefit is that patients are now getting more ‘fun’ things, like home-delivered meals, air quality cleaning products, and things like that are really expanding the role of what a health insurance company can do to address their beneficiaries while also expanding the definition is of healthcare.”

Secondly, Giglierano said, more health plans are paying for the supplemental benefits through the Centers for Medicare & Medicaid Services benchmarks and approval policies.

Incentives to address beneficiary care

“So now, health plans have an incentive to properly address beneficiary care and attain higher utilization of low-cost preventative care, in order to get more money to use toward supplemental benefits,” he said.

In an analysis of the Advantage competition for 2023 Giglierano found that fitness benefits continue to be the most popular preventive supplemental benefit. The number of plans offering memory fitness benefits, which have grown rapidly in popularity, grew from 949 in 2022 to 1,308 in 2023, a nearly 40% increase.

But spurred by regulatory changes and the COVID-19 pandemic, other benefits have begun to catch up, he found.

Other rapidly growing benefits include in-home support services and support for caregivers of enrollees. Offerings for these benefits grew by 50% and 83%, respectively, as the COVID-19 pandemic drove a major increase in in-home services and drew attention to the need for more support for members and their caregivers.

“MAOs that offer innovative, appealing supplemental benefits will have the competitive edge,"Faegre Drinker Biddle & Reath report

“MAOs that offer innovative, appealing supplemental benefits will have the competitive edge," said Giglierano’s report, which was co-authored by Kacy Dugan, director of policy & regulatory affairs at Faegre Drinker. “As MAOs consider their benefit design strategy for their 2024 bids, they should consider expanding their benefit offerings to reflect the needs and wants of their target populations.”

Meanwhile, the government said this week that Affordable Care Act Marketplace enrollment continues to move at a fast pace. Nearly 5.5 million people have selected an ACA Marketplace health plan nationwide since the start of the 2023 open enrollment period that extends until next month.

Total plan selections include 1.2 million peopled (22%) who are new to the marketplaces for 2023, and 4.3 million people (78%), who have active 2022 coverage and returned to their respective marketplaces to renew or select a new plan for 2023. The 5.5 million total plan selections represent an 18% increase from 4.6 million this time last year.

“We are off to a strong start – and we will not rest until we can connect everyone possible to health care coverage this enrollment season,” said HHS Secretary Xavier Becerra. “The Biden-Harris Administration has taken historic action to expand access to health care, and ensure everyone can have the peace of mind that comes with being insured.”

Doug Bailey is a journalist and freelance writer who lives outside of Boston. He can be reached at [email protected].

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Doug Bailey is a journalist and freelance writer who lives outside of Boston. He can be reached at [email protected].