BELLINGHAM, Wash.--(BUSINESS WIRE)--Proposed changes to 2025 Medicare plans are expected to send shockwaves across the healthcare industry and are foretelling major disruption for all Medicare patients when they confront their Annual Enrollment Period (AEP) later this year. Amidst this turmoil, the nation’s largest Medicare insurance-solution network for hospitals, health systems, physician groups and pharmacies is encouraging providers to step up their communication efforts and be the “trusted voice of information” in their communities.
“The Inflation Reduction Act and new CMS Final Rules will radically change benefits, premiums, patient co-pays and network participation across the entire Medicare landscape,” said MedicareCompareUSA’s CEO Kerri Lenderman. “That makes it more critical than ever for hospitals and medical groups to take a leading role in educating seniors -- particularly those currently enrolled in Medicare Advantage plans and standalone Prescription Drug Plans -- about how these changes will impact their cost, coverage and access. It also makes it imperative for providers to internally prepare for how these changes will profoundly affect their own organization. And the time to start planning for all if this is now.”
As an example, Lenderman says that reduced reimbursement and increased utilization in Medicare Advantage plans will cause many of insurers to adjust premiums, modify pharmaceutical formularies, change provider networks and, in some cases, pull out of counties completely that they no longer find profitable. “All of this will cause major stress for seniors as it will disrupt continuity of care and long-standing patient-provider relationships. It will also have a dramatic effect on hospitals who will need to prepare accordingly for these changes.”
To help in this task, an increasing number of providers nationwide are referring patients to MCUSA’s MedicareOnDemand (MOD) before and during the AEP for a free insurance assessment aimed at ensuring a smooth 2025 insurance transition for both them and their patients. This online platform makes it easy for seniors to match Medicare insurance options with plans accepted by their physicians, preferred pharmacy and hospital. Through MOD consumers can easily compare Medicare Advantage, Medicare Supplement and Medicare Prescription Drug plans online, create a customized shopping experience and speak with a licensed agent via videochat, phone, or in person to review 2025 plan changes.
To further support these efforts, MCUSA has updated its highly-successful “turning 65 patient communication campaign” to include a “Medicare Patient Orientation” offered both in classroom style and one-on-one with a licensed agent. This program is designed to help patients better understand and navigate Medicare, including the value of original Medicare and the precautions patients should take if considering Medicare Advantage.
“CMS has received thousands of complaints from beneficiaries not understanding Medicare or their insurance options when they enroll,” says Lenderman. “As a result, insurance distribution has been under great scrutiny for a number of years with CMS continuing to impose new requirements on agents and agencies as well as on how marketing resources are allocated to providers and insurers.”
More than 65 million Americans are currently enrolled in Medicare, over half of whom are in Medicare Advantage. CMS projects that the Medicare population will increase 60% by 2031 and double by 2040.
About MedicareCompareUSA
As the nation’s leader in its space, MedicareCompareUSA currently supports more than 650 hospitals, health systems, physician groups and pharmacies from coast to coast who collectively care for more than 10% of the nation’s Medicare population. With its strong foundation and impressive track record, an increasing number of hospitals and doctors are looking to MedicareCompareUSA and its sister company, MCUSA Consulting, as an indispensable part of a proactive patient-communication and population-management strategy. Visit https://medicareondemand.com and https://medicarecompareusa.com.
