As Medicare Advantage Enrollment Grows, CMS Expands Access, Equity, and Increases Beneficiary Protection

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Patrick Phillips, CEO of Cavulus

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Cavulus CEO Patrick Phllips said the new CMS rules further boost the popularity of Medicare Advantage and Part D.

“MA enrollment statistics have grown 10% annually in recent years and within a year are expected to represent 50% of all Medicare coverage selections.”

—Patrick Phillips

PITTSBURGH, PENNSYLVANIA, USA, June 15, 2022 /EINPresswire.com/ — The Centers for Medicare and Medicaid Services (CMS) recently announced new rules to advance their “strategic vision.”

According to Patrick Phillips, CEO of Cavulus, an industry-leading technology provider, the new CMS rules further boost the popularity of Medicare Advantage (MA) and Part D. They expand access to health care and improve health equity through lower prescription drug costs for consumers and improved consumer protection.

Phillips says the costs and benefits of MA attract membership. Enrollment statistics have grown 10% annually in recent years and within a year are expected to represent 50% of all Medicare coverage selections.

However, Phillips acknowledges that “the program is not without criticism due to its rapid growth. That’s why there are guardrails in place. CMS has levers they can pull through regulatory oversight. »

For example, the CEO of Cavulus likes a new regulation that takes into account a plan’s past performance and grants CMS the ability to decline new contracts or service area extensions for underperforming insurers. “It allows the best performing plans to grow and limits organizations that tarnish the integrity of the program.” As a result, he sees the gap between over-performing and under-performing plans inevitably widening through competition.

In addition to countless new rules benefiting existing MA members, CMS is also looking at how plans are marketed to potential enrollees. Phillips points out that federal agencies are cracking down on the use of third-party marketing organizations (TPMOs) that have garnered attention via TV ads featuring celebrity spokespersons.

“Because our company facilitates the marketing, sales, and master’s enrollment process, we understand the issues,” Phillips said. “We’re proud of how Cavulus has helped advance CMS’s mission, and that’s why we monitor all new regulations and incorporate them into our workflows. Our solutions enable monitoring, CMS compliance and consistency of marketing messages.

Phillips points out that MA plans are ultimately responsible for any downstream entity they use, including TPMOs. “Member-centric plans continue to attract interest from those aging in Medicare, while plans that lag behind attract more attention from CMS.”

ABOUT CAVULUS – Cavulus is a technology-driven specialist in Medicare Advantage insurance solutions. The Cavulus Cloud Medicare Advantage (Cavulus MAP™) platform unifies marketing, sales, and enrollment operations, and is used by many leading U.S. insurers, including multiple BlueCross/BlueShield companies, UPMC Health Plan, Johns Hopkins, Lumeris and United Healthcare. For more details, visit: www.cavulus.com.

Paul-Luc
Cavulus
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