HealthLeaders-InterStudy, the leading provider of managed care market intelligence, reports that from January 2008 to July 2008 Medicare Advantage enrollment grew by one million to more than 9.9 million members, an increase of 11 percent. Details of this growth, and other enrollment information, can be found in the latest release of Managed Market Surveyor-Rx, a database product from HealthLeaders-InterStudy that delivers medical and pharmacy benefit enrollment by managed care organization and geography.
"Consumers are converting from stand-alone plans to the more managed products that Medicare Advantage plans provide, which have deeper benefits," said Jane DuBose, Director of Health Plan Analysis for HealthLeaders-InterStudy. "Additionally, there's a lot of marketing around Medicare Advantage plans that increases consumer awareness about these options and has likely contributed to their growth."
According to HealthLeaders-InterStudy data, about 35 percent of the Medicare Advantage growth can be attributed to increases in private fee-for-service plan membership. From January 2008 to July 2008, membership in these plans increased by nearly 350,000 lives.
There are many factors driving the popularity of private fee-for-service plans. With no network restrictions and a structure similar to supplement plans with which many seniors are familiar, they are attractive to consumers. For insurers, there's a low barrier for entry as private fee-for-service plans do not require the establishment of provider networks. However, recent changes in Medicare Advantage legislation requires private fee-for-service operators to create networks in counties where another network-based plan exists by 2011.
"We'll likely see membership in private fee-for-service plans begin to stabilize over the next two years as carriers begin to shift members to HMO or PPO plans," said DuBose. "Large insurers with large networks in place should be able to more easily shift membership to HMO or PPO options, but smaller insurers will need to work harder to establish the networks needed to meet the new requirement. While the new requirement will shift Medicare Advantage membership across the board, it will have a significant impact on Medicare Advantage membership in urban areas where network options are more readily available."
Why Pharmaceutical Companies Need Managed Market Surveyor-Rx
Managed Market Surveyor-Rx delivers medical and pharmacy benefit enrollment data by managed care organization and geography (national, state, MSA) to better inform strategic planning and resource allocation. Relying on primary research and HealthLeaders-InterStudy's proprietary validation methodology, Managed Market Surveyor-Rx provides the most accurate managed care database available.
HealthLeaders-InterStudy, a Decision Resources, Inc. company, is the authoritative source for managed care data, analysis and news. For more information, please visit www.HL-ISY.com.
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