Growth Through Innovation: Sustainable Strategies to Win the Medicare Advantage Market with Product Innovation

How can regional payers compete against the industry giants?

The Medicare Advantage (MA) market is experiencing unprecedented growth, but with fierce competition from a few major players accounting for 2 in 3 new enrollees, how can regional health plans increase their share of the market? In this blog, we’ll explore the landscape, the misconception that innovation requires vast resources, and the key to success for regional players.

Competition is Fierce

According to a Chartis report, the average member has access to 44 different plan options, a remarkable annual growth rate of 11%. However, industry giants account for a significant 65% of all new enrollment. While regional non-profits are seeing an increase in an annual enrollment, their share of the market is still declining.

The continued surge in 5-star plans adds an extra layer of competition. With two-thirds of the MA population having access to these plans, more members are switching ahead of the Annual Enrollment Period (AEP). As a result, member acquisition during this crucial period is even more dependent on the superiority of the plan with the intensified competition.

Misconception: Innovation Requires Vast Resources

Contrary to common belief, driving innovation in the MA market doesn’t demand copious amounts of capital, resources, and people — if you have a smart technology solution. Implementing systems that ensure compliance, remove the need for manual work, automate repetitive tasks, and connect data to output with accuracy can streamline operations. Health plans achieve:

• Streamlined year-over-year plan management
• More efficient change management
• Less time required for auditing and validation

The right product data management solution empowers regional health plans to achieve more with less resources, leveling the playing field with their national counterparts.

Innovate to Differentiate

Regional health plans may face a competitive MA market, but they hold a distinct advantage in their local markets with established relationships, community involvement, and a commitment to providing intimate customer service. For consumers, particularly seniors, the emphasis on the personal connection is distinctive. If regional plans can offer equivalent benefits at a comparable cost to national plans but with the added personal touch, they secure their home field advantage and take a bigger piece of the MA market.