The insights into plan features, particularly the expansion of supplemental benefits and continued reliance on prior authorization for skilled nursing care, underscore the need for facilities to stay informed about MA plan offerings in their local markets. This knowledge empowers facilities to proactively adapt their services, refine marketing strategies to attract MA beneficiaries seeking specific benefits, and navigate increasingly complex utilization management processes to ensure timely access to care and accurate reimbursement.
This brief provides information about Medicare Advantage plans in 2024, including premiums, out-of-pocket limits, supplemental benefits, and prior authorization, as well as trends over time. A companion analysis examines trends in Medicare Advantage enrollment.
While data on Medicare Advantage plan availability, enrollment and plan offerings is robust, the same cannot be said about service utilization (especially for supplemental benefits) and out-of-pocket spending patterns (though some of this data is starting to be collected), which would allow assessment of how well the program is meeting its goals in terms of value and quality and help Medicare beneficiaries compare coverage options. As enrollment in Medicare Advantage and federal payments to private plans continue to grow, greater transparency and more comprehensive information will become increasingly relevant for people with Medicare program oversight. Highlights for 2024
Freed, M., Biniek, J. F., Damico, A., & Neuman, T. (2024, August 8). Medicare advantage in 2024: premiums, Out-of-Pocket limits, supplemental benefits, and prior authorization | KFF. KFF. https://www.kff.org/medicare/issue-brief/medicare-advantage-in-2024-premiums-out-of-pocket-limits-supplemental-benefits-and-prior-authorization/
Improve Medicare Advantage reimbursements with payer contract management that puts payer rules in the hands of clinicians & billers.
