B部分的溢价购买会留在这里吗？2023年的前景和2024年的考虑

MILLIMANWHITE PAPER Is thePart Bpremiumbuydownheretostay?2023landscapeandconsiderationsfor 2024 Philip Nelson, FSA, CERA, MAAAJeremy Hamilton, FSA, MAAAAli Heinrich, FSA, MAAA TheMedicare Advantage (MA)marketcontinues to groweach year,bothinterms ofenrollmentand the number of plan offerings.In2023, theaverageMedicare-eligibleindividualcanchoosefrommore than40 plans,an increase ofabout13% compared to 2022.1As the market continuesto grow,plan sponsorsseek toadd competitive benefits toretain currentmembers andattractnewenrollmentboth from Medicarefee-for-service(FFS) and competitorMAplans. In recent years,someMA plans have included abenefit to offseta portion ofbeneficiaries’Part Bpremiumsatincreasing rateseach year.In thispaper, weprovideinsightsintothecurrent2023landscapeof thePart Bpremiumbuydown(also referred to asPart Bgiveback, Part B subsidy,orPart Bbuydown), as wellashistorical markettrendsand considerations forplan sponsors for the2024plan yearandbeyond.Throughoutthis paper,we will refer to thisbenefit asaPart Bbuydown. Executivesummary Whetherthey are covered byMedicare FFS orenroll inan MAplan,non-dual eligibleMedicare beneficiaries mustpay a monthly Part B premium to help fund the medical costs associated with thegovernment-sponsoredMedicarePart B program (typically professional and outpatient medical services).2This premium, in most cases, is deductedfrom a beneficiary’s monthly Social Security (SS) disbursements.3Notably, the 2022 Part B premium($170.10)increased $21.60,or 14.5%,relativetothe2021PartB premium($148.50),4whichled to increased visibilityof thispremiumfor manyMedicare-eligible individuals. Theincreasesin Part B premium havecoincided with several years ofnotableincreasesinMArevenue payments.To remain competitive, Medicare Advantageorganizations(MAOs) havelargelyinvested thisincreased revenue inricher supplemental benefits offerings, includingofferingvalue to beneficiaries in the form of reduced Part BpremiumsthroughPart Bbuydowns. In our analysis,we usedthe2020 through 2023 versions of theMilliman MACVAT®to summarize the current 2023landscape of plans with a Part B buydownand examinehow this landscape has changed over the last few years,looking atbothspecific plan characteristicsandtheMedicare Advantagemarket as a whole.We limited our analysis tonon-special needs plans (non-SNPs), specifically looking at HMO, HMO-POS, LPPO, and RPPO MA plans in theindividual market in the United States (excluding all United States territories). Wefocused on the following key metrics: 1.The number of plans offering a Part B buydown2.Members enrolled in plans offering a Part B buydown3.The average dollar amount of the Part B buydown ThePart Bbuydownbenefithas grownsignificantlyacrosseach of thesemetricsover thelast few years. Wehighlightthe growth inthese metricsin Figure 1. Enrollment in Part B buydowns has also grown at a significantly higher rate than inplans without the Part B buydownbenefit, as illustrated in Figure 6. Drilling down further into the MA landscapemayprovide insight into MAO strategieswhen offeringPart B buydowns.In our analysis,we observed the following: Benefit combination strategies:Some plans offeredhigherPart Bbuydownsalongsideleanermedical benefitplans(compared to average medical benefits)to attractthe typicallylower-utilizing beneficiaries,while otherplansincludedhighPart Bbuydownson rich medical plans togo “all in” for membership growth.MA-PD vs.MA-only:Over80%of beneficiariesenrolled inMA-onlyplansare ina planofferinga Part Bbuydown(versus 7% ofbeneficiaries enrolled inMA-PD plans),indicatingthattheMA-onlymarket may be at apoint whereoffering aPart Bbuydownis a requirement to be competitive on benefit offerings.Geographicaldifferences:Analyzing the landscape by state revealedclear variationin both the prevalence andaverage amount of thePart Bbuydown,depending on the area of the country. To be successful in offering the Part B buydown benefit,MAOs must understandthemarket dynamics as well as thefinancial impactsof thebenefit.Though a valuable enticement benefit,aPart Bbuydownoftencomesat significantfinancialcost to plansthat offer itfor the following reasons: Utilization:It is a fully utilizedbenefit,meaningthat an MAO must pay this Part B buydown amount each monthfor every member (including dual eligible members) enrolled in the plan.Supplementalbenefitfunding:Part B buydowns are considered a supplemental benefit, whichmust be fundedthrough MA rebates (derived from bid savings, less the portion of savings shared with CMS5), which meansplans must sacrifice margin dollars that exceed the dollar value of the benefit.Visibility:The benefitis not tangibleandmay beless “visible” to somebeneficiaries.Beneficiariesin an MA planwithaPart B buydownthat areless attuned to their Part B premium paymentmay not realizethattheir SSdisbursement is higher than it otherwise would have been(as theMAplan funds a portionof the Part B premium). The enrollment growth potentia